1326068503 NPI number — THOMAS E. HAMILTON MD

Table of content: MR. JOHNNIE L FLAGG RPH (NPI 1316962004)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326068503 NPI number — THOMAS E. HAMILTON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMILTON
Provider First Name:
THOMAS
Provider Middle Name:
E.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326068503
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1340 HAL GREER BOULEVARD
Provider Second Line Business Mailing Address:
ATTN: TAMMIE SILVA
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25701-3800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-526-2053
Provider Business Mailing Address Fax Number:
304-526-2547

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1340 HAL GREER BOULEVARD
Provider Second Line Business Practice Location Address:
ATTN: TAMMIE SILVA
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25701-3800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-526-2053
Provider Business Practice Location Address Fax Number:
304-526-2547
Provider Enumeration Date:
07/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  34517 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 19422 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0048671000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00711764 . This is a "MEDICARE - RR CABELL HUNTINGTON HOSPITAL" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 000000377988 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7397211 . This is a "MEDICARE - CABELL HUNTINGTON HOSPITAL" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: P00264747 . This is a "RR-MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 64345176 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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