Basic Information
Provider Information
NPI: 1336384965
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SPRINGER
FirstName: STEPHEN
MiddleName: H
NamePrefix: MR.
NameSuffix:  
Credential: MS CCC-A
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2900 HAWKINS DR
Address2:  
City: SEARCY
State: AR
PostalCode: 721434802
CountryCode: US
TelephoneNumber: 5012782846
FaxNumber: 5012783001
Practice Location
Address1: 2900 HAWKINS DR
Address2:  
City: SEARCY
State: AR
PostalCode: 721434802
CountryCode: US
TelephoneNumber: 5012782846
FaxNumber: 5012783001
Other Information
ProviderEnumerationDate: 12/11/2008
LastUpdateDate: 12/11/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000XA#86ARY Speech, Language and Hearing Service ProvidersAudiologist 

ID Information
IDTypeStateIssuerDescription
5223301 MEDICAREOTHER


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