Provider Demographics
NPI:1265278931
Name:HAMILTON, JARRETT
Entity type:Individual
Prefix:
First Name:JARRETT
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17385
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38187-0385
Mailing Address - Country:US
Mailing Address - Phone:901-319-4885
Mailing Address - Fax:901-379-8637
Practice Address - Street 1:6867 KELMSCOTT DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-8407
Practice Address - Country:US
Practice Address - Phone:901-319-4885
Practice Address - Fax:901-379-8637
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10354207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services