Provider Demographics
NPI:1255379970
Name:HAMLETT, SEAN R (DO)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:R
Last Name:HAMLETT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1205 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-2125
Mailing Address - Country:US
Mailing Address - Phone:573-355-0929
Mailing Address - Fax:573-234-6301
Practice Address - Street 1:1205 W BROADWAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2125
Practice Address - Country:US
Practice Address - Phone:573-355-0929
Practice Address - Fax:573-234-6301
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002010578207RE0101X
OK3759207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKH60331Medicare UPIN