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Organization
GREAT WESTERN MEDICAL GROUP PLLC
Active
Organization
GREAT WESTERN MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ADAM HAMILTON MD (OWNER)
(218) 770-9881
Entity
Organization
Contact information
Practice address
118 PAUL BUNYAN DR S, BEMIDJI, MN 56601-3236
(218) 770-9881
Mailing address
118 PAUL BUNYAN DR S, BEMIDJI, MN 56601-3236
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
53573
MN
Other
Enumeration date
11/17/2017
Last updated
11/17/2017
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