Provider Demographics
NPI:1023373149
Name:HAMISTER, AARON J (MHPP)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:J
Last Name:HAMISTER
Suffix:
Gender:M
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 BOB COURTWAY DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-4766
Mailing Address - Country:US
Mailing Address - Phone:501-328-5525
Mailing Address - Fax:501-328-5342
Practice Address - Street 1:1100 BOB COURTWAY DR
Practice Address - Street 2:SUITE 9
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4766
Practice Address - Country:US
Practice Address - Phone:501-328-5525
Practice Address - Fax:501-328-5342
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator