Provider Demographics
NPI:1487846739
Name:HAMILTON ORTHOPAEDIC CLINIC, INC
Entity Type:Organization
Organization Name:HAMILTON ORTHOPAEDIC CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CANGEMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-524-1100
Mailing Address - Street 1:10 N LOCUST ST
Mailing Address - Street 2:SUITE B 1
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-1192
Mailing Address - Country:US
Mailing Address - Phone:513-524-1100
Mailing Address - Fax:513-524-0085
Practice Address - Street 1:10 N LOCUST ST
Practice Address - Street 2:SUITE B 1
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1192
Practice Address - Country:US
Practice Address - Phone:513-524-1100
Practice Address - Fax:513-524-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36511207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100001310Medicaid
OH0336827Medicaid
OH9150462Medicare PIN
OHA74770Medicare UPIN
OH0342780001Medicare NSC