Provider Demographics
NPI:1801823174
Name:HAMBLETON, DANIEL C (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:C
Last Name:HAMBLETON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:635 HWY 20 NORTH
Mailing Address - Street 2:SUITE # 4
Mailing Address - City:HINES
Mailing Address - State:OR
Mailing Address - Zip Code:97738
Mailing Address - Country:US
Mailing Address - Phone:541-573-3339
Mailing Address - Fax:541-573-3366
Practice Address - Street 1:635 HWY 20 NORTH
Practice Address - Street 2:SUITE # 4
Practice Address - City:HINES
Practice Address - State:OR
Practice Address - Zip Code:97738
Practice Address - Country:US
Practice Address - Phone:541-573-3339
Practice Address - Fax:541-573-3366
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD164756207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine