Provider Demographics
NPI:1699745547
Name:HAMLETT, JAMES M III (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:HAMLETT
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6215 HUMPHREYS BLVD
Mailing Address - Street 2:STE 310
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2367
Mailing Address - Country:US
Mailing Address - Phone:901-747-0291
Mailing Address - Fax:901-747-0299
Practice Address - Street 1:6215 HUMPHREYS BLVD
Practice Address - Street 2:STE 310
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2367
Practice Address - Country:US
Practice Address - Phone:901-747-0291
Practice Address - Fax:901-747-0299
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7009174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3896301Medicaid
3896301Medicare ID - Type Unspecified
B59238Medicare UPIN