Provider Demographics
NPI:1962426296
Name:HAMILTON, ASHLEY STOOKSBURY (OD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:STOOKSBURY
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 FIREWOOD LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6057
Mailing Address - Country:US
Mailing Address - Phone:865-300-6165
Mailing Address - Fax:865-909-7169
Practice Address - Street 1:4620 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919
Practice Address - Country:US
Practice Address - Phone:865-584-7739
Practice Address - Fax:865-909-7169
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD2461152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4070743OtherBLUE CROSS
TN3942648Medicare PIN
TN3945874Medicare PIN
TN4070743OtherBLUE CROSS
TN3896230001Medicare NSC
TNP00305847Medicare PIN