Provider Demographics
NPI:1285730572
Name:THE HAMILTON CLINIC, INC.
Entity type:Organization
Organization Name:THE HAMILTON CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:580-765-3900
Mailing Address - Street 1:425 FAIRVIEW AVE
Mailing Address - Street 2:#3
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601-1902
Mailing Address - Country:US
Mailing Address - Phone:580-765-3900
Mailing Address - Fax:580-765-7256
Practice Address - Street 1:425 FAIRVIEW AVE
Practice Address - Street 2:#3
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-1902
Practice Address - Country:US
Practice Address - Phone:580-765-3900
Practice Address - Fax:580-765-7256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1451101YP2500X
OK3506101YP2500X
OK212103TC0700X
OK18251041C0700X
OK99342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty