Provider Demographics
NPI:1053334953
Name:HAMILTON, WILLIAM MARK (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:MARK
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 N WIMBERLY DR FL 2
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4056
Mailing Address - Country:US
Mailing Address - Phone:479-587-3117
Mailing Address - Fax:479-587-3185
Practice Address - Street 1:3317 N WIMBERLY DR FL 2
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4056
Practice Address - Country:US
Practice Address - Phone:479-587-3117
Practice Address - Fax:479-587-3185
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1039824174400000X
AROTR1534225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist