Healthcare Provider Details

I. General information

NPI: 1992781496
Provider Name (Legal Business Name): SCOTT HAMEL PT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 N HWY 66
CATOOSA OK
74015
US

IV. Provider business mailing address

1110 W WILL ROGERS BLVD
CLAREMORE OK
74017-5421
US

V. Phone/Fax

Practice location:
  • Phone: 918-342-3800
  • Fax: 918-342-3900
Mailing address:
  • Phone: 918-342-3800
  • Fax: 918-342-3900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2891
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: