Individual
DAVID THEODORE HAMILOS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
508 PRINCETON RD, STE 202, JOHNSON CITY, TN 37601-2063
(423) 926-2741
(423) 926-5782
Mailing address
508 PRINCETON RD, SUITE 202, JOHNSON CITY, TN 37601-2060
(423) 926-2741
(423) 926-5782
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000284
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000284
TN PODIATRY LICENSE
TN
05
—
3351538
—
TN
01
—
85440
BCBS OF TENNESSEE
TN
Enumeration date
10/17/2005
Last updated
03/25/2020
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