Provider Demographics
NPI:1710931027
Name:HAMILTON, TIFFANI K (MD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANI
Middle Name:K
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11800 ATLANTIS PL
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1160
Mailing Address - Country:US
Mailing Address - Phone:770-360-8881
Mailing Address - Fax:770-255-2533
Practice Address - Street 1:11800 ATLANTIS PL
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1160
Practice Address - Country:US
Practice Address - Phone:770-360-8881
Practice Address - Fax:770-255-2533
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA045491207N00000X, 207ND0101X, 207ND0900X, 207NI0002X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G76167Medicare UPIN
GA07BBSJZMedicare ID - Type Unspecified