Provider Demographics
NPI:1275684417
Name:HAMILTON, JOHN A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:HAMILTON
Suffix:
Gender:M
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:PO BOX 322
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36601-0322
Mailing Address - Country:US
Mailing Address - Phone:251-433-3781
Mailing Address - Fax:251-431-5810
Practice Address - Street 1:305 N. WATER ST.
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36602
Practice Address - Country:US
Practice Address - Phone:251-433-3781
Practice Address - Fax:251-431-5810
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD229662083X0100X
AL229662083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-45863OtherBLUE CROSS PROV ID-IMC
E63799Medicare UPIN
AL510-45863OtherBLUE CROSS PROV ID-IMC