Healthcare Provider Details

I. General information

NPI: 1265472013
Provider Name (Legal Business Name): THOMAS A HAMLETT CRNAP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 09/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 HOSPITAL DR
MARTINSVILLE VA
24112-8526
US

IV. Provider business mailing address

2600 SNOW CREEK RD
MARTINSVILLE VA
24112-8526
US

V. Phone/Fax

Practice location:
  • Phone: 276-666-7388
  • Fax:
Mailing address:
  • Phone: 276-632-4777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024137378
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: