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General NPI Number Information
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NPI Number | 1225682529
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Entity Type | Organization
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Legal Business Name | HAMLIN MEDICAL INNOVATIONS LLC
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Dates
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Enumeration Date | 07/25/2019
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Last Update Date | 07/08/2021
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Provider Practice Location Address
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Address Line | 1001 W DAUGHERTY ST
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City | WEBB CITY
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State | MO
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Zip | 64870-1717
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Country | US
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Telephone | 417-717-2017
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Fax | 417-717-2134
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Provider Business Mailing Address
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Address Line | 6031 SOUTH MAIN STREET RD #334
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City | WEBB CITY
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State | MO
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Zip | 64870-1717
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Country | US
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Telephone | 417-548-3334
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Fax | 417-548-3335
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Authorized Official
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Title or Position | OWNER
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Name | JUSTIN HAMLIN
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Credential | DO
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Telephone | 417-717-2017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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