Basic Information
Provider Information
NPI: 1063546588
EntityType: 2
ReplacementNPI:  
OrganizationName: MICHAEL F HAMANT MD PC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 43100
Address2:  
City: TUCSON
State: AZ
PostalCode: 857333100
CountryCode: US
TelephoneNumber: 5207223777
FaxNumber: 5202966224
Practice Location
Address1: 6761 E TANQUE VERDE RD
Address2: SUITE 6
City: TUCSON
State: AZ
PostalCode: 857155323
CountryCode: US
TelephoneNumber: 5202982313
FaxNumber: 5202981554
Other Information
ProviderEnumerationDate: 03/15/2007
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HAMANT
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName: F
AuthorizedOfficialTitleorPosition: OWNER PRESIDENT
AuthorizedOfficialTelephone: 5202982313
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QM2500X14809AZY Ambulatory Health Care FacilitiesClinic/CenterMedical Specialty

No ID Information.


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