Healthcare Provider Details

I. General information

NPI: 1700865110
Provider Name (Legal Business Name): RANDY HAMILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 MEMORIAL DR
DALTON GA
30720-2529
US

IV. Provider business mailing address

300 W HOSPITAL RD
FORT GORDON GA
30905-5741
US

V. Phone/Fax

Practice location:
  • Phone: 706-272-6000
  • Fax:
Mailing address:
  • Phone: 706-787-4631
  • Fax: 706-787-4632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number036168
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: