Individual
TRAVIS HAMBLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5300 S SUTTER DR STE 1, SHOW LOW, AZ 85901-8055
(928) 532-7546
(923) 532-7547
Mailing address
PO BOX 1792, HIGLEY, AZ 85236-1792
(928) 532-7546
(923) 532-7547
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
006585
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006156
—
AZ
01
—
Z176975
PTAN
AZ
Enumeration date
06/28/2011
Last updated
09/25/2024
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