Provider Demographics
NPI:1134468226
Name:HAMILTON, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3990 BROOKS AVE
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31503-0525
Mailing Address - Country:US
Mailing Address - Phone:912-286-1180
Mailing Address - Fax:912-287-6689
Practice Address - Street 1:3990 BROOKS AVE
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31503-0525
Practice Address - Country:US
Practice Address - Phone:912-286-1180
Practice Address - Fax:912-287-6689
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator