Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 648 | AZ |
NPI | 1033206131 |
---|---|
Provider Name | Dr. Jarrett Wesley Hamilton |
First Address | Sierra Vista, AZ 85635-2860 |
Second Address | Sierra Vista, AZ 85635-4606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 05/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
193106 | (05) | AZ |
V11475 | (02) | AZ |