Provider Demographics
NPI:1447226675
Name:HAMILTON, ALAN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:WILLIAM
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 EAST BELL ROAD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6010
Mailing Address - Country:US
Mailing Address - Phone:602-354-3172
Mailing Address - Fax:602-354-3173
Practice Address - Street 1:5425 EAST BELL ROAD
Practice Address - Street 2:SUITE 145
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6010
Practice Address - Country:US
Practice Address - Phone:602-354-3172
Practice Address - Fax:602-354-3173
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21450207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ142472Medicaid
Z77161Medicare ID - Type Unspecified
AZZ157491Medicare PIN
AZ142472Medicaid