Basic Information
Provider Information
NPI: 1003203969
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMILTON
FirstName: DAVID
MiddleName: SPENCER
NamePrefix: DR.
NameSuffix: SR.
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3601 S 6TH AVE
Address2:  
City: TUCSON
State: AZ
PostalCode: 857230001
CountryCode: US
TelephoneNumber: 5207921450
FaxNumber:  
Practice Location
Address1: 3601 S 6TH AVE
Address2:  
City: TUCSON
State: AZ
PostalCode: 857231716
CountryCode: US
TelephoneNumber: 5207921450
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/17/2015
LastUpdateDate: 06/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/21/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X63203AZY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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