Provider Demographics
NPI:1073711313
Name:HAMILTON, BRIAN SCHERTZ (M D)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:SCHERTZ
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 N STATE ST
Mailing Address - Street 2:STE 502
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-2414
Mailing Address - Country:US
Mailing Address - Phone:601-944-1781
Mailing Address - Fax:601-353-0439
Practice Address - Street 1:1190 N STATE ST
Practice Address - Street 2:STE 502
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-2414
Practice Address - Country:US
Practice Address - Phone:601-944-1781
Practice Address - Fax:601-353-0439
Is Sole Proprietor?:No
Enumeration Date:2007-07-09
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20895174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06817082Medicaid
MS1073711313Medicare PIN