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NPI Code Detail

MEDICARE: DR. SCOTT R HAMBLIN M.D.

MEDICARE: DR. SCOTT R HAMBLIN M.D.
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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972594620
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT R HAMBLIN M.D.
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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 11/21/2007

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