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
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000XHAS-T-10136830ORN Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 
237700000XHAS-P-10136935-ORORY Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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