Provider Demographics
NPI:1861480329
Name:HAMILTON, ELLEN R (PT)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:R
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3234 CAHABA HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-1614
Mailing Address - Country:US
Mailing Address - Phone:205-298-9101
Mailing Address - Fax:
Practice Address - Street 1:3234 CAHABA HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-1614
Practice Address - Country:US
Practice Address - Phone:205-298-9101
Practice Address - Fax:205-298-9103
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH579225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALQ48604Medicare UPIN
AL051528469HAMMedicare PIN