Provider Demographics
NPI:1487631289
Name:HAMILTON, DAVID LEMAR (PA-C, MPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEMAR
Last Name:HAMILTON
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Gender:M
Credentials:PA-C, MPH
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Mailing Address - Street 1:1650 COCHRANE CIR
Mailing Address - Street 2:BLDG 7505
Mailing Address - City:FORT CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4613
Mailing Address - Country:US
Mailing Address - Phone:719-526-2092
Mailing Address - Fax:719-526-7732
Practice Address - Street 1:1650 COCHRANE CIR
Practice Address - Street 2:BLDG 7505
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4613
Practice Address - Country:US
Practice Address - Phone:719-526-2092
Practice Address - Fax:719-526-7732
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2016-02-03
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Provider Licenses
StateLicense IDTaxonomies
1033611363A00000X
NY011211-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN