Provider Demographics
NPI:1043090962
Name:DAVID V HAMILTON MD PLLC
Entity Type:Organization
Organization Name:DAVID V HAMILTON MD PLLC
Other - Org Name:AGENTIC MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-284-5980
Mailing Address - Street 1:1200 FIVE SPRINGS RD STE 201
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-8756
Mailing Address - Country:US
Mailing Address - Phone:434-283-5980
Mailing Address - Fax:434-284-5964
Practice Address - Street 1:1200 FIVE SPRINGS RD STE 201
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-8756
Practice Address - Country:US
Practice Address - Phone:434-283-5980
Practice Address - Fax:434-284-5964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty