Provider Demographics
NPI:1164508057
Name:HAMILTON, JESSE J (OD)
Entity Type:Individual
Prefix:DR
First Name:JESSE
Middle Name:J
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:4569 ENGLISH CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1308
Mailing Address - Country:US
Mailing Address - Phone:513-226-2460
Mailing Address - Fax:513-829-6560
Practice Address - Street 1:5482 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-4108
Practice Address - Country:US
Practice Address - Phone:513-226-2460
Practice Address - Fax:513-829-6560
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2014-11-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH2468T5554152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1164508057Medicare NSC