Provider Demographics
NPI:1477234490
Name:HAMILTON, SARAH JOAN
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JOAN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 ABBY LOOP
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-9143
Mailing Address - Country:US
Mailing Address - Phone:501-881-8281
Mailing Address - Fax:
Practice Address - Street 1:250 ABBY LOOP
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-9143
Practice Address - Country:US
Practice Address - Phone:501-881-8281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSTUDENT363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant