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General NPI Number Information
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NPI Number | 1932244522
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Entity Type | Individual
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Provider Name | TOM ALLEN HAMILTON
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Gender | Male
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2046 W AUBURN RD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-3628
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Country | US
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Telephone | 248-852-8830
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Fax | 248-852-6937
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Provider Business Mailing Address
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Address Line | 2046 AUBURN RD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309
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Country | US
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Telephone | 248-852-8830
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Fax | 248-852-6937
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901002556
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License Number State | MI
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