Healthcare Provider Details

I. General information

NPI: 1427037530
Provider Name (Legal Business Name): KIRSTEN LYN HAMACHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: K. LYN HAMACHER MD

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 S 56TH ST STE 110
PHOENIX AZ
85034-2177
US

IV. Provider business mailing address

PO BOX 42210
PHOENIX AZ
85080-2210
US

V. Phone/Fax

Practice location:
  • Phone: 602-685-5211
  • Fax: 602-685-5325
Mailing address:
  • Phone: 623-266-7770
  • Fax: 623-322-4639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number35883
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number35883
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: