Provider Demographics
NPI:1467606277
Name:HAMILTON, BRIAN J (RN)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:J
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6903 S310TH E AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014
Mailing Address - Country:US
Mailing Address - Phone:918-691-4059
Mailing Address - Fax:
Practice Address - Street 1:6903 S310E AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OH
Practice Address - Zip Code:74014
Practice Address - Country:US
Practice Address - Phone:918-691-4059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0066384163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse