Provider Demographics
NPI:1689889255
Name:HAMILTON, MARK J (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 823
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-0823
Mailing Address - Country:US
Mailing Address - Phone:903-752-0612
Mailing Address - Fax:
Practice Address - Street 1:500 HIGHWAY 37 S
Practice Address - Street 2:
Practice Address - City:MT VERNON
Practice Address - State:TX
Practice Address - Zip Code:75457-6550
Practice Address - Country:US
Practice Address - Phone:903-537-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1667207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine