Provider Demographics
NPI:1265472013
Name:HAMLETT, THOMAS A (CRNAP)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:HAMLETT
Suffix:
Gender:M
Credentials:CRNAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 SNOW CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-8526
Mailing Address - Country:US
Mailing Address - Phone:276-632-4777
Mailing Address - Fax:
Practice Address - Street 1:370 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-8526
Practice Address - Country:US
Practice Address - Phone:276-666-7388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024137378367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010087449Medicaid
VA004930M11Medicare ID - Type Unspecified
VA010087449Medicaid