Provider Demographics
NPI:1780220343
Name:HAMILTON, REBECCA S
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:S
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 LINDSEY RD
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:MS
Mailing Address - Zip Code:39117
Mailing Address - Country:US
Mailing Address - Phone:601-259-9917
Mailing Address - Fax:
Practice Address - Street 1:1306 LINDSEY RD
Practice Address - Street 2:6824 HWY 13 SOUTH
Practice Address - City:MORTON
Practice Address - State:MS
Practice Address - Zip Code:39117
Practice Address - Country:US
Practice Address - Phone:601-259-9917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider