Healthcare Provider Details

I. General information

NPI: 1417971755
Provider Name (Legal Business Name): RONALD D HAMILTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 W LEXINGTON AVE
WINCHESTER KY
40391-1169
US

IV. Provider business mailing address

1431 CENTERPOINT BLVD SUITE 100
KNOXVILLE TN
37932-1984
US

V. Phone/Fax

Practice location:
  • Phone: 859-745-3500
  • Fax:
Mailing address:
  • Phone: 888-203-1274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number23060
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number23060
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: