Healthcare Provider Details

I. General information

NPI: 1164545232
Provider Name (Legal Business Name): MILTON HAMMERLY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3464 S DOWNING ST
ENGLEWOOD CO
80113-2911
US

IV. Provider business mailing address

3464 S DOWNING ST
ENGLEWOOD CO
80113-2911
US

V. Phone/Fax

Practice location:
  • Phone: 877-897-3993
  • Fax: 877-897-3993
Mailing address:
  • Phone: 303-805-1714
  • Fax: 877-897-3993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number29594
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: