Provider Demographics
NPI:1194894675
Name:HAMILTON, DAVID JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JOSEPH
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3660 WOODFIELD PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-1230
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2325 18TH ST
Practice Address - Street 2:SUITE 130
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-5387
Practice Address - Country:US
Practice Address - Phone:812-379-2020
Practice Address - Fax:812-378-8267
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01033574A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000088173OtherANTHEM BCBS
IN100343080Medicaid
IN000000984926OtherANTHEM PIN
IN010272POtherSIHO
KY64756570OtherKENTUCKY MEDICAID
060011064OtherPALMETTA GBA RAILROAD MC
ININ2762061Medicare PIN
IN100343080Medicaid