MEDICARE: PHILLIP HAMILTON DC

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	111N00000X	Chiropractor	12434095-1202	UT
2	111N00000X	Chiropractor	B01944	NV

General Provider Information

NPI Number	:	1538894241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILLIP HAMILTON DC

Provider Business Mailing Address
First Line	:	1778 N VANTAGE POINT DR
Second Line	:
City	:	WASHINGTON
State	:	UT
Zip	:	84780-1360
Country	:	US
Telephone Number	:	425-941-4170
Fax Number	:

Provider Business Practice Location Address
First Line	:	840 PINNACLE CT STE 5A
Second Line	:
City	:	MESQUITE
State	:	NV
Zip	:	89027-3322
Country	:	US
Telephone Number	:	702-346-5030
Fax Number	:

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

Provider Enumeration Date	:	07/18/2022
Last Update Date	:	06/12/2024

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Directions to “ PHILLIP HAMILTON DC” Practice Location

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