Provider Demographics
NPI:1831141522
Name:HAMILTON, KEVIN D (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:D
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC-PC
Mailing Address - Street 1:2028 E. 38TH ST.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-1807
Mailing Address - Country:US
Mailing Address - Phone:563-344-6060
Mailing Address - Fax:563-344-6061
Practice Address - Street 1:2028 E. 38TH ST.
Practice Address - Street 2:SUITE 2
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-1807
Practice Address - Country:US
Practice Address - Phone:563-344-6060
Practice Address - Fax:563-344-6061
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05394111N00000X
IAAO5394111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA05686OtherBCBS
IA0747485Medicaid
IA0747485Medicaid
IA05686OtherBCBS