Provider Demographics
NPI:1437119567
Name:HAMILTON, WALTER (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:
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 2048
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36652-2048
Mailing Address - Country:US
Mailing Address - Phone:251-432-4117
Mailing Address - Fax:251-436-7765
Practice Address - Street 1:1956 DUVAL ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36106
Practice Address - Country:US
Practice Address - Phone:251-471-3747
Practice Address - Fax:251-450-1445
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.26045207P00000X, 208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009936706Medicaid
AL515-32809OtherBCBS
AL009936703Medicaid
AL515-39038OtherBCBS
AL515-39039OtherBCBS
AL009935872Medicaid
AL515-33209OtherBCBS
AL009937952Medicaid
AL515-33210OtherBCBS
AL009935386Medicaid
AL1437119567OtherTRICARE SOUTH
AL51523826OtherBCBS
AL009936704Medicaid
AL515-33211OtherBCBS
AL631403151Medicaid
AL009935872Medicaid
AL051532809Medicare PIN
AL515-32809OtherBCBS
AL515-39039OtherBCBS
AL631403151Medicaid