Provider Demographics
NPI:1306831375
Name:HAMILTON, GERALD B (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:B
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:23401 PRAIRIE STAR PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66227-7268
Mailing Address - Country:US
Mailing Address - Phone:913-677-6319
Mailing Address - Fax:913-677-1540
Practice Address - Street 1:23401 PRAIRIE STAR PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66227-7268
Practice Address - Country:US
Practice Address - Phone:913-677-6319
Practice Address - Fax:913-677-1540
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-28867208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM400052405OtherMEDICARE
KS04-28867OtherKANSAS LICENSE
KS1306831375OtherTAX ID #
IN200521560AMedicaid
IN200521560AMedicaid
INH61884Medicare UPIN