=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073716247
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RACHEL M. HAMILTON DDS,MSD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3215 MALL RD STE.O
-----------------------------------------------------
City | ANDERSON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29625-1715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-225-6005
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3215 MALL RD STE.O
-----------------------------------------------------
City | ANDERSON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29625-1715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR
-----------------------------------------------------
Name | RACHEL M. HAMILTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 864-225-6005
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number | 3845
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------