Provider Demographics
NPI:1083052294
Name:HAMLET RADIOLOGY, PLLC
Entity Type:Organization
Organization Name:HAMLET RADIOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:STAAB
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:910-690-6934
Mailing Address - Street 1:160 PITCH PINE LN
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9217
Mailing Address - Country:US
Mailing Address - Phone:910-690-6934
Mailing Address - Fax:
Practice Address - Street 1:1000 W HAMLET AVE
Practice Address - Street 2:MEDICAL IMAGING DEPARTMENT
Practice Address - City:HAMLET
Practice Address - State:NC
Practice Address - Zip Code:28345-4522
Practice Address - Country:US
Practice Address - Phone:910-690-6934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-10
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty