Individual
MR. TOM DAVID HAZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
49 TALENT AVE, TALENT, OR 97540-9638
(541) 773-3863
Mailing address
1221 DISK DR, MEDFORD, OR 97501-6638
(458) 658-5930
(541) 414-1123
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
083042659
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032842
—
OR
05
—
136114
—
OR
Enumeration date
06/30/2005
Last updated
04/23/2026
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