Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 7310292-1205 | UT |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | R0986 | KY |
NPI | 1356488126 |
---|---|
Provider Name | Dr. Sanford Todd Hamilton |
First Address | Provo, UT 84604-3305 |
Second Address | American Fork, UT 84003-2845 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 13/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7310292-1205 | STATE LICENSE (01) | UT |