Provider Demographics
NPI:1942382726
Name:HAMILTON, EDWARD WILLIAM JR (DO)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:WILLIAM
Last Name:HAMILTON
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4215 WOODRUFF RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-6889
Mailing Address - Country:US
Mailing Address - Phone:706-653-6080
Mailing Address - Fax:706-653-6052
Practice Address - Street 1:4215 WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6889
Practice Address - Country:US
Practice Address - Phone:706-653-6080
Practice Address - Fax:706-653-6052
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA053922207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA143392709DMedicaid
GAI11895Medicare UPIN