=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184681116
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LESLIE A HAMILTON RD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/26/2006
-----------------------------------------------------
Last Update Date | 07/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2670 ROUNDTOP RD
-----------------------------------------------------
City | ELIZABETHTOWN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42701-7204
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-259-6400
-----------------------------------------------------
Fax | 290-259-9524
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2670 ROUNDTOP RD
-----------------------------------------------------
City | ELIZABETHTOWN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42701-7204
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-259-6400
-----------------------------------------------------
Fax | 290-259-9524
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number | 897496
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------