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General NPI Number Information
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NPI Number | 1568637643
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Entity Type | Organization
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Legal Business Name | ROBERT L HAMILTON DO PC
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 6011 PORTER RD
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City | GRAND BLANC
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State | MI
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Zip | 48439-8538
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Country | US
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Telephone | 810-695-1122
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Fax | 810-695-5711
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Provider Business Mailing Address
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Address Line | 6011 PORTER RD
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City | GRAND BLANC
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State | MI
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Zip | 48439-8538
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Country | US
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Telephone | 810-695-1122
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Fax | 810-695-5711
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ROBERT LEROY HAMILTON
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Credential | D.O.
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Telephone | 810-695-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101008048
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License Number State | MI
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