Provider Demographics
NPI:1407952575
Name:HAMILTON, RODNEY MACK (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:MACK
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5111 MARYLAND WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7513
Mailing Address - Country:US
Mailing Address - Phone:615-661-4256
Mailing Address - Fax:615-661-4253
Practice Address - Street 1:5111 MARYLAND WAY
Practice Address - Street 2:SUITE 301
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7513
Practice Address - Country:US
Practice Address - Phone:615-661-4256
Practice Address - Fax:615-661-4253
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD36569208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
BH8062084OtherDEA
BH8062084OtherDEA