Provider Demographics
NPI:1467453431
Name:HAMILTON, GEOFFREY ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:ROBERT
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 1:1180 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-1126
Mailing Address - Country:US
Mailing Address - Phone:404-253-8900
Mailing Address - Fax:401-253-3131
Practice Address - Street 1:1180 HOPE ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-1126
Practice Address - Country:US
Practice Address - Phone:404-253-8900
Practice Address - Fax:401-253-3131
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD 10625207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI04-06667OtherUNITED HEALTH CARE
RI9025999Medicaid
RI0000025999OtherB/S
RI697728OtherHARVARD PILGRIM HEALTH
RI010625OtherTUFTS HEALTH PLAN
RI408518OtherBCHIP
RI4249OtherNEIGHBORHOOD HEALTH
RI408518OtherBCHIP