MEDICARE: DR. HAMILTON BROWN D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	3789-15	MS

General Provider Information

NPI Number	:	1043691603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAMILTON BROWN D.M.D.

Provider Business Mailing Address
First Line	:	1313 W HIGHWAY 8
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-2240
Country	:	US
Telephone Number	:	662-843-8353
Fax Number	:

Provider Business Practice Location Address
First Line	:	1313 W HIGHWAY 8
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-2240
Country	:	US
Telephone Number	:	662-843-8353
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2015
Last Update Date	:	06/09/2015

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