Individual
MRS. MARY BOLAND HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 HUMPHREYS SUITE 230, MEMPHIS, TN 38117
(901) 259-2440
(225) 767-6721
Mailing address
80 HUMPHREYS SUITE 230, MEMPHIS, TN 38117
(901) 259-2440
(225) 767-6721
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
657
710916908
LA
Enumeration date
05/15/2009
Last updated
02/05/2019
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