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NPI Code Detail

MEDICARE: KEITH ALLEN HAMILTON

MEDICARE: KEITH ALLEN HAMILTON
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
1101YM0800XMental Health Counselor
2171M00000XCase Manager/Care CoordinatorOH

General Provider Information

NPI Number : 1497433965
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH ALLEN HAMILTON
Provider Business Mailing Address
First Line : PO BOX 402
Second Line :
City : WHEELERSBURG
State : OH
Zip : 45694-0402
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9620 CAREYS RUN POND CREEK RD
Second Line :
City : MC DERMOTT
State : OH
Zip : 45652-3902
Country : US
Telephone Number : 740-858-6683
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2023
Last Update Date : 12/07/2023

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