Provider Demographics
NPI:1851383806
Name:HAMILL, DAVID W (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:HAMILL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 2ND LOOP RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-2848
Mailing Address - Country:US
Mailing Address - Phone:843-679-9900
Mailing Address - Fax:843-679-9988
Practice Address - Street 1:514 2ND LOOP RD
Practice Address - Street 2:SUITE E
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-2848
Practice Address - Country:US
Practice Address - Phone:843-679-9900
Practice Address - Fax:843-679-9988
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0891152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDA9695Medicaid
SC8232Medicare PIN
SCDA9695Medicaid