Provider Demographics
NPI:1801336540
Name:HAMILTON, BILLY JR
Entity type:Individual
Prefix:
First Name:BILLY
Middle Name:
Last Name:HAMILTON
Suffix:JR
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 1:1547 7TH ST
Mailing Address - Street 2:
Mailing Address - City:HUGHSON
Mailing Address - State:CA
Mailing Address - Zip Code:95326-9132
Mailing Address - Country:US
Mailing Address - Phone:209-505-1727
Mailing Address - Fax:
Practice Address - Street 1:1547 7TH ST
Practice Address - Street 2:
Practice Address - City:HUGHSON
Practice Address - State:CA
Practice Address - Zip Code:95326-9132
Practice Address - Country:US
Practice Address - Phone:209-505-1727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator