Healthcare Provider Details

I. General information

NPI: 1558347047
Provider Name (Legal Business Name): DANIEL L HAMILOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S CRESCENT DR
MASON CITY IA
50401-2926
US

IV. Provider business mailing address

250 S CRESCENT DR
MASON CITY IA
50401-2926
US

V. Phone/Fax

Practice location:
  • Phone: 641-494-5380
  • Fax:
Mailing address:
  • Phone: 641-494-5380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number219164
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License Number219164
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number219164
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number52071
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: