Provider Demographics
NPI:1295065373
Name:HAMILTON, ANTHONY (PA-C)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 W CENTRAL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3819
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2130 W CENTRAL AVENUE
Practice Address - Street 2:#101, #102, #103
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606
Practice Address - Country:US
Practice Address - Phone:419-291-3900
Practice Address - Fax:419-479-6055
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003900RX363AM0700X
MI5601005525363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical