MEDICARE: DR. HAROLD BRUCE 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	207T00000X	Neurological Surgery Physician	K1462	TX
2	207T00000X	Neurological Surgery Physician	MD020855	LA
3	207T00000X	Neurological Surgery Physician	A53187	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8F23439	OTHER		MEDICARE PTAN
2	P00788761	OTHER		RAILROAD MEDICARE
4	140005555	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	0062CJ	OTHER	TX	BLUE CROSS BLUE SHIELD
5	8V8480	OTHER	TX	BLUECROSS BLUESHIELD
6	5292421	OTHER	TX	AETNA
7	8CF004	OTHER		BCBS
8	114423102	OTHER	TX	FIRSTCARE
9	99670	OTHER	TX	SCOTT & WHITE
10	P00383121	OTHER	TX	RR MCR PTAN
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	53403	OTHER	TX	BLUELINK

General Provider Information

NPI Number	:	1457356255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAROLD BRUCE HAMILTON M.D.

Provider Business Mailing Address
First Line	:	205 WOODHEW DR
Second Line	:	STE 200
City	:	WACO
State	:	TX
Zip	:	76712-6689
Country	:	US
Telephone Number	:	254-776-9775
Fax Number	:	254-776-9751

Provider Business Practice Location Address
First Line	:	205 WOODHEW DR
Second Line	:	STE 200
City	:	WACO
State	:	TX
Zip	:	76712-6689
Country	:	US
Telephone Number	:	254-776-9775
Fax Number	:	254-776-9751

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	10/20/2011

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Directions to “ DR. HAROLD BRUCE HAMILTON M.D.” Practice Location

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