MEDICARE: DR. TODD HAMILTON O.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	152W00000X	Optometrist	2000160793	MO

General Provider Information

NPI Number	:	1306934823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD HAMILTON O.D.

Provider Business Mailing Address
First Line	:	1120 WOLFRUM RD
Second Line	:	STE. 106
City	:	WELDON SPRING
State	:	MO
Zip	:	63304-7898
Country	:	US
Telephone Number	:	636-447-2244
Fax Number	:	636-447-2213

Provider Business Practice Location Address
First Line	:	1120 WOLFRUM RD
Second Line	:	STE. 106
City	:	WELDON SPRING
State	:	MO
Zip	:	63304-7898
Country	:	US
Telephone Number	:	636-447-2244
Fax Number	:	636-447-2213

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	06/07/2012

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