Basic Information
| Provider Information | |||||||||
| NPI: | 1629188933 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMLAT | ||||||||
| FirstName: | CHRISTIAN | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 190 E BANNOCK ST | ||||||||
| Address2: | |||||||||
| City: | BOISE | ||||||||
| State: | ID | ||||||||
| PostalCode: | 83712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2083812222 | ||||||||
| FaxNumber: | 2067448582 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 N 1ST ST. 1 | ||||||||
| Address2: | |||||||||
| City: | BOISE | ||||||||
| State: | ID | ||||||||
| PostalCode: | 83702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2083456545 | ||||||||
| FaxNumber: | 2083451213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 04/06/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD00046664 | WA | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | MD00046664 | WA | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | MD00046664 | WA | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0129X | M12013 | ID | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.