Provider Demographics
NPI:1821226598
Name:HAMILTON, JOSEPH JOHN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:JOHN
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11303 SUMMIT POINT CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-6466
Mailing Address - Country:US
Mailing Address - Phone:661-302-5053
Mailing Address - Fax:661-588-0451
Practice Address - Street 1:11303 SUMMIT POINT CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-6466
Practice Address - Country:US
Practice Address - Phone:661-302-5053
Practice Address - Fax:661-588-0451
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16355363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP71387Medicare UPIN