Provider Demographics
NPI:1437176211
Name:HAMILTON, JULIE PASHLEY (PAC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:PASHLEY
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ELIZABETH
Other - Last Name:PASHLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4093
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:385 STATE ST
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:PA
Practice Address - Zip Code:17801-2531
Practice Address - Country:US
Practice Address - Phone:570-286-6773
Practice Address - Fax:570-286-7967
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051442207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAQ01822Medicare UPIN
PAQ01822Medicare UPIN