Provider Demographics
NPI:1962688432
Name:REAVEY, HAMILTON ELIZABETH (MD)
Entity Type:Individual
Prefix:MRS
First Name:HAMILTON
Middle Name:ELIZABETH
Last Name:REAVEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HAMILTON
Other - Middle Name:ELIZABETH
Other - Last Name:FRYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3495 PIEDMONT ROAD, NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-364-7070
Mailing Address - Fax:
Practice Address - Street 1:20 GLENLAKE PARKWAY
Practice Address - Street 2:KAISER PERMANENTE GLENLAKE MEDICAL CENTER
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:404-712-4686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0020602085R0202X
GA0675972085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology