Provider Demographics
NPI:1497830780
Name:HAMILTON, CLARANCE FLETCHER JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:CLARANCE
Middle Name:FLETCHER
Last Name:HAMILTON
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 INDEPENDENCE PLZ
Mailing Address - Street 2:SUITE 716
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2629
Mailing Address - Country:US
Mailing Address - Phone:205-871-0031
Mailing Address - Fax:205-803-1280
Practice Address - Street 1:1 INDEPENDENCE PLZ
Practice Address - Street 2:SUITE 716
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-2629
Practice Address - Country:US
Practice Address - Phone:205-871-0031
Practice Address - Fax:205-803-1280
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL278103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL00278OtherBROOKWOOD
AL630831461OtherCHAMPUS
AL70564OtherBC/BS
AL00278OtherBROOKWOOD
ALR62074Medicare UPIN