Healthcare Provider Details
I. General information
NPI: 1710198759
Provider Name (Legal Business Name): TIMOTHY THOMAS HAMILTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/24/2007
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8530 W SUNSET RD STE 110
LAS VEGAS NV
89113-2244
US
IV. Provider business mailing address
801 S RANCHO DR STE E6
LAS VEGAS NV
89106-3812
US
V. Phone/Fax
- Phone: 702-240-6482
- Fax:
- Phone: 702-240-6482
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | 12249 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: