Provider Demographics
NPI:1457004681
Name:GRAHAM A HAMILTON
Entity Type:Organization
Organization Name:GRAHAM A HAMILTON
Other - Org Name:GRAHAM A HAMILTON DPM PA
Other - Org Type:Other Name
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:
Authorized Official - First Name:GRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-708-2932
Mailing Address - Street 1:1310 WONDER WORLD DR STE 115
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-8351
Mailing Address - Country:US
Mailing Address - Phone:512-301-5350
Mailing Address - Fax:
Practice Address - Street 1:1310 WONDER WORLD DR STE 115
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-8351
Practice Address - Country:US
Practice Address - Phone:512-301-5350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty