Provider Demographics
NPI:1639136831
Name:HAMILTON, FREDERICK JAMES (DO)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:JAMES
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 603898
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3898
Mailing Address - Country:US
Mailing Address - Phone:843-431-2280
Mailing Address - Fax:843-431-2297
Practice Address - Street 1:2835 E HIGHWAY 76
Practice Address - Street 2:SUITE 5
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-6038
Practice Address - Country:US
Practice Address - Phone:843-431-2280
Practice Address - Fax:843-431-2297
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYC1037207X00000X
SC00378207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC209392OtherONE HEALTH PLAN
WV1060998OtherWORKERS COMPENSATION
NC89065MPMedicaid
SCTL0763Medicaid
NY0599092OtherGHI
SC4073601OtherAETNA
SC60887OtherMEDCOST
PA01903060Medicaid
SCC09392OtherPHYSICIANS CARE NETWORK
SC209392OtherONE HEALTH PLAN
WV1060998OtherWORKERS COMPENSATION