1336115724 NPI number — JANET T HILES-BRETT MCD

Table of content: JANET T HILES-BRETT MCD (NPI 1336115724)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336115724 NPI number — JANET T HILES-BRETT MCD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILES-BRETT
Provider First Name:
JANET
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MCD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TINSLEY
Provider Other First Name:
JANET
Provider Other Middle Name:
MICHIKO
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336115724
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/13/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 91734
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23291-1734
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-358-6100
Provider Business Mailing Address Fax Number:
804-342-7619

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1250 E MARSHALL ST
Provider Second Line Business Practice Location Address:
AUDIOLOGY
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23298-5051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-828-0431
Provider Business Practice Location Address Fax Number:
804-628-0950
Provider Enumeration Date:
02/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  2201000629 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)