Provider Demographics
NPI:1346496551
Name:HAMILTON, THOMAS SCOTT (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:SCOTT
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2807 ARIZONA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-3181
Mailing Address - Country:US
Mailing Address - Phone:417-781-6722
Mailing Address - Fax:417-781-2090
Practice Address - Street 1:2807 ARIZONA AVE SUITE 2
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804
Practice Address - Country:US
Practice Address - Phone:417-781-6722
Practice Address - Fax:417-781-2090
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011008662207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100747570AMedicaid
OK200343430AMedicaid
MO1346496551Medicaid
KS200875380AMedicaid
MOMA2082265Medicare PIN