Provider Demographics
NPI:1891151585
Name:HAMILTON, ROBERT EDWARD III
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:EDWARD
Last Name:HAMILTON
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 68TH ST NW
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35967-8300
Mailing Address - Country:US
Mailing Address - Phone:706-233-9023
Mailing Address - Fax:
Practice Address - Street 1:6 MATHIS DR NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1242
Practice Address - Country:US
Practice Address - Phone:706-233-9023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)