Provider Demographics
NPI:1013796333
Name:HAMILTON, ANITRA J
Entity Type:Individual
Prefix:
First Name:ANITRA
Middle Name:J
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8430 FAIRLANE DR
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-2033
Mailing Address - Country:US
Mailing Address - Phone:770-820-2124
Mailing Address - Fax:
Practice Address - Street 1:8430 FAIRLANE DR
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-2033
Practice Address - Country:US
Practice Address - Phone:770-820-2124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor