Provider Demographics
NPI:1760462618
Name:HAMILTON, KENNETH E (DO)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:E
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3347
Mailing Address - Country:US
Mailing Address - Phone:918-488-6001
Mailing Address - Fax:
Practice Address - Street 1:6465 S YALE AVE STE 615
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7808
Practice Address - Country:US
Practice Address - Phone:918-502-4600
Practice Address - Fax:918-502-4605
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005036202207V00000X
OK3112207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200089811Medicaid
MO221288OtherBLUE CROSS
MO956385133Medicare Oscar/Certification
MO221288OtherBLUE CROSS