Provider Demographics
NPI:1083645279
Name:HAMILTON, JONI O (OT)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:O
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 HILLCREST PKWY
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-4207
Mailing Address - Country:US
Mailing Address - Phone:478-275-1800
Mailing Address - Fax:478-275-2233
Practice Address - Street 1:911 HILLCREST PKWY
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-4207
Practice Address - Country:US
Practice Address - Phone:478-275-1800
Practice Address - Fax:478-275-2233
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT003997225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6035Medicare ID - Type UnspecifiedMEDICARE GROUP #
GAQ65888Medicare UPIN