Provider Demographics
NPI:1205830296
Name:HAMILTON, JAMES T (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:T
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 B EAST 32ND STREET
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804
Mailing Address - Country:US
Mailing Address - Phone:417-624-8408
Mailing Address - Fax:417-624-7828
Practice Address - Street 1:2531 B EAST 32ND STREET
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804
Practice Address - Country:US
Practice Address - Phone:417-624-8408
Practice Address - Fax:417-624-7828
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000631213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO302852306Medicaid
MO000021429Medicare ID - Type Unspecified
MO302852306Medicaid