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General NPI Number Information
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NPI Number | 1285730572
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Entity Type | Organization
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Legal Business Name | THE HAMILTON CLINIC, INC.
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 425 FAIRVIEW AVE #3
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City | PONCA CITY
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State | OK
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Zip | 74601-1902
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Country | US
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Telephone | 580-765-3900
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Fax | 580-765-7256
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Provider Business Mailing Address
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Address Line | 425 FAIRVIEW AVE #3
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City | PONCA CITY
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State | OK
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Zip | 74601-1902
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Country | US
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Telephone | 580-765-3900
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Fax | 580-765-7256
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM C HAMILTON JR.
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Credential | M.D.
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Telephone | 580-765-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1451
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 212
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1825
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 9934
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License Number State | OK
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3506
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License Number State | OK
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