Provider Demographics
NPI:1528001286
Name:HAMILTON, LAWRENCE D JR (DC)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:D
Last Name:HAMILTON
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 OLD ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7747
Mailing Address - Country:US
Mailing Address - Phone:724-834-8364
Mailing Address - Fax:
Practice Address - Street 1:209 OLD ROUTE 30
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7747
Practice Address - Country:US
Practice Address - Phone:724-834-8364
Practice Address - Fax:724-834-8364
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003799L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA60093OtherUNISON
PA093946OtherBCBS
PA1156285Medicaid
PAU07240Medicare UPIN
PA60093OtherUNISON