Provider Demographics
NPI:1225263742
Name:HAMILTON, KATHIE GAY (LMT)
Entity Type:Individual
Prefix:MS
First Name:KATHIE
Middle Name:GAY
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 NORTH FANT STREET
Mailing Address - Street 2:ANDERSON
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621
Mailing Address - Country:US
Mailing Address - Phone:864-222-1748
Mailing Address - Fax:864-222-1748
Practice Address - Street 1:405 N FANT ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-5715
Practice Address - Country:US
Practice Address - Phone:864-222-1748
Practice Address - Fax:864-222-1748
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2011-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1202174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist