Provider Demographics
| NPI: | 1164037263 |
|---|---|
| Name: | HAMILTON, RAMON ALEXANDER (DPT) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | RAMON |
| Middle Name: | ALEXANDER |
| Last Name: | HAMILTON |
| Suffix: | |
| Gender: | M |
| Credentials: | DPT |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 540 DON NICHOLAS RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | TAOS |
| Mailing Address - State: | NM |
| Mailing Address - Zip Code: | 87571-6437 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 917-583-7681 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 101 HERDNER RD UNIT C |
| Practice Address - Street 2: | |
| Practice Address - City: | TAOS |
| Practice Address - State: | NM |
| Practice Address - Zip Code: | 87571-5362 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 575-613-1093 |
| Practice Address - Fax: | 575-613-1093 |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2020-09-15 |
| Last Update Date: | 2020-09-15 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| CO | PTL.0015430 | 2251C2600X, 2251E1200X, 2251G0304X, 2251N0400X, 2251P0200X, 2251S0007X, 2251X0800X, 225100000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | |
| No | 2251C2600X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Cardiopulmonary |
| No | 2251E1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Ergonomics |
| No | 2251G0304X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics |
| No | 2251N0400X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology |
| No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics |
| No | 2251S0007X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports |
| No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
