Provider Demographics
NPI:1225682529
Name:HAMLIN MEDICAL INNOVATIONS LLC
Entity Type:Organization
Organization Name:HAMLIN MEDICAL INNOVATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:417-717-2017
Mailing Address - Street 1:6031 SOUTH MAIN STREET
Mailing Address - Street 2:RD #334
Mailing Address - City:WEBB CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64870-1717
Mailing Address - Country:US
Mailing Address - Phone:417-548-3334
Mailing Address - Fax:417-548-3335
Practice Address - Street 1:1001 W DAUGHERTY ST
Practice Address - Street 2:
Practice Address - City:WEBB CITY
Practice Address - State:MO
Practice Address - Zip Code:64870-1717
Practice Address - Country:US
Practice Address - Phone:417-717-2017
Practice Address - Fax:417-717-2134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-25
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty