Healthcare Provider Details

I. General information

NPI: 1396765038
Provider Name (Legal Business Name): WILLIAM CLAUDE HAMILTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 01/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E 19TH ST
THE DALLES OR
97058-3317
US

IV. Provider business mailing address

1700 E 19TH ST
THE DALLES OR
97058-3317
US

V. Phone/Fax

Practice location:
  • Phone: 541-506-6424
  • Fax: 541-296-7650
Mailing address:
  • Phone: 541-506-6424
  • Fax: 541-296-7650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD14571
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: