Provider Demographics
NPI:1194127068
Name:T SCOTT HAMILTON DO PC
Entity type:Organization
Organization Name:T SCOTT HAMILTON DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:T SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:417-529-9546
Mailing Address - Street 1:2807 ARIZONA AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-3174
Mailing Address - Country:US
Mailing Address - Phone:417-781-6722
Mailing Address - Fax:
Practice Address - Street 1:2807 ARIZONA AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3174
Practice Address - Country:US
Practice Address - Phone:417-781-6722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011008662207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty