MEDICARE: WILLIAM C HAMILTON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	9934	OK

General Provider Information

NPI Number	:	1235152265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM C HAMILTON M.D.

Provider Business Mailing Address
First Line	:	425 FAIRVIEW AVE STE 3
Second Line	:
City	:	PONCA CITY
State	:	OK
Zip	:	74601-1924
Country	:	US
Telephone Number	:	580-765-3900
Fax Number	:	580-765-7256

Provider Business Practice Location Address
First Line	:	425 FAIRVIEW AVE STE 3
Second Line	:
City	:	PONCA CITY
State	:	OK
Zip	:	74601-1924
Country	:	US
Telephone Number	:	580-765-3900
Fax Number	:	580-765-7256

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	07/08/2007

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