Healthcare Provider Details

I. General information

NPI: 1154267441
Provider Name (Legal Business Name): CLAYTON HAMILTON NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 W MAIN ST
BERNE IN
46711-1796
US

IV. Provider business mailing address

1100 MERCER AVE
DECATUR IN
46733-2303
US

V. Phone/Fax

Practice location:
  • Phone: 260-724-2145
  • Fax:
Mailing address:
  • Phone: 260-724-2145
  • Fax: 260-728-3867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71018247A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: