Provider Demographics
NPI:1033235288
Name:HAMILTON, DARREN ANSON (DC)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:ANSON
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:IN
Mailing Address - Zip Code:47446-1330
Mailing Address - Country:US
Mailing Address - Phone:812-849-4495
Mailing Address - Fax:812-849-3402
Practice Address - Street 1:905 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:IN
Practice Address - Zip Code:47446-1330
Practice Address - Country:US
Practice Address - Phone:812-849-4495
Practice Address - Fax:812-849-3402
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001639111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U66661Medicare UPIN
494720Medicare ID - Type Unspecified