Basic Information
Provider Information | |||||||||
NPI: | 1285948398 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | AUGUR | ||||||||
FirstName: | ROBERT | ||||||||
MiddleName: | J | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: | JR. | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 5000 CHESHIRE PKWY N | ||||||||
Address2: |   | ||||||||
City: | PLYMOUTH | ||||||||
State: | MN | ||||||||
PostalCode: | 554464103 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7632684332 | ||||||||
FaxNumber: | 7632684017 | ||||||||
Practice Location | |||||||||
Address1: | 11942 NE GLISAN ST | ||||||||
Address2: |   | ||||||||
City: | PORTLAND | ||||||||
State: | OR | ||||||||
PostalCode: | 972202143 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5032523238 | ||||||||
FaxNumber: | 5032538654 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/30/2010 | ||||||||
LastUpdateDate: | 03/06/2012 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237700000X | HAS-T-10136830 | OR | N |   | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |   | 237700000X | HAS-P-10136935-OR | OR | Y |   | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |   |
No ID Information.