Provider Demographics
NPI:1912537499
Name:HAMILTON, LYNDSAY D
Entity Type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:D
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LYNDSAY
Other - Middle Name:D
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:614 E CHICKASAW AVE
Mailing Address - Street 2:
Mailing Address - City:SALLISAW
Mailing Address - State:OK
Mailing Address - Zip Code:74955-4810
Mailing Address - Country:US
Mailing Address - Phone:918-571-0644
Mailing Address - Fax:
Practice Address - Street 1:614 E CHICKASAW AVE
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-4810
Practice Address - Country:US
Practice Address - Phone:918-571-0644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator