Provider Demographics
NPI:1356780654
Name:HAMILTON, FAITH BENNIGAN (BS, RDMS, RVT, ARRT)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:BENNIGAN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:BS, RDMS, RVT, ARRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1827
Mailing Address - Street 2:
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-1827
Mailing Address - Country:US
Mailing Address - Phone:307-438-9844
Mailing Address - Fax:
Practice Address - Street 1:755 WOOD ST
Practice Address - Street 2:
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-2155
Practice Address - Country:US
Practice Address - Phone:307-438-9844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYGN-1523-102471S1302X, 2471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography