Provider Demographics
NPI:1003864554
Name:HAMLIN, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:HAMLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 96846
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73143-6846
Mailing Address - Country:US
Mailing Address - Phone:405-632-2323
Mailing Address - Fax:405-631-9315
Practice Address - Street 1:100 N. 30TH ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-3831
Practice Address - Country:US
Practice Address - Phone:405-632-2323
Practice Address - Fax:405-631-9315
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK180532085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731539623001OtherBC/BS
OK100218590AMedicaid
F71608Medicare UPIN
OK$$$$$$$$$RMedicare PIN