Provider Demographics
NPI:1184655342
Name:HAMILTON, DEBORAH K (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:K
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3099 HELMSDALE PL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2213
Mailing Address - Country:US
Mailing Address - Phone:859-258-6401
Mailing Address - Fax:859-255-1480
Practice Address - Street 1:3099 HELMSDALE PL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2213
Practice Address - Country:US
Practice Address - Phone:859-258-6401
Practice Address - Fax:859-255-1480
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36806207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY37903705OtherMEDICAID LAB GRP
GACB5773OtherRR MEDICARE GRP
KY4000501OtherMEDICARE LAB GRP
KY64034598Medicaid
KY37903705OtherMEDICAID LAB GRP
KY0971001Medicare ID - Type Unspecified
F74204Medicare UPIN
KY64034598Medicaid