Provider Demographics
NPI:1003385733
Name:JAMES G HAMILTON JR MD LLC
Entity Type:Organization
Organization Name:JAMES G HAMILTON JR MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:706-754-7485
Mailing Address - Street 1:PO BOX 1615
Mailing Address - Street 2:
Mailing Address - City:CLARKESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30523-0027
Mailing Address - Country:US
Mailing Address - Phone:706-754-7485
Mailing Address - Fax:
Practice Address - Street 1:4898 HIGHWAY 197
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:GA
Practice Address - Zip Code:30563-2442
Practice Address - Country:US
Practice Address - Phone:706-499-7290
Practice Address - Fax:706-754-0160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty