Organization
AUDIOLOGY & HEARING AID SERVICES
Active
Organization
AUDIOLOGY & HEARING AID SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES ROGER FAGAN AU.D. (OWNER)
(207) 797-8738
Entity
Organization
Contact information
Practice address
985 FOREST AVE, PORTLAND, ME 04103-3303
(207) 797-8738
(207) 797-8650
Mailing address
985 FOREST AVE, PORTLAND, ME 04103-3303
(207) 797-8738
(207) 797-8650
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
AP1825
ME
237600000X
Audiologist-Hearing Aid Fitter
Primary
AP25
ME
237700000X
Hearing Instrument Specialist
DL20000383
ME
Other
Enumeration date
06/03/2008
Last updated
06/03/2008
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