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NPI Code Detail

MEDICARE: SCOTT R HAMBLIN MD, PC

MEDICARE: SCOTT R HAMBLIN MD, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician23187AZ

General Provider Information

NPI Number : 1790974830
Entity Type Code : Organization
Provider Name (Legal Business Name) : SCOTT R HAMBLIN MD, PC
Provider Business Mailing Address
First Line : PO BOX 1610
Second Line :
City : SPRINGERVILLE
State : AZ
Zip : 85938-1610
Country : US
Telephone Number : 928-333-5333
Fax Number : 928-333-5100
Provider Business Practice Location Address
First Line : 606 N MAIN ST
Second Line :
City : EAGAR
State : AZ
Zip : 85925-9813
Country : US
Telephone Number : 928-333-5333
Fax Number : 928-333-5100
Authorized Official
Title or Position : OFFICE MANAGER
Name : MS. LORI LESUEUR
Credential :
Telephone Number : 928-333-5333
Provider Enumeration Date : 10/15/2007
Last Update Date : 08/27/2009

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Directions to “SCOTT R HAMBLIN MD, PC ” Practice Location

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