MEDICARE: KEVIN CHARLES 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	OEG001111	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558395137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN CHARLES HAMILTON O.D.

Provider Business Mailing Address
First Line	:	610 REMBRANDT CIR
Second Line	:
City	:	IRWIN
State	:	PA
Zip	:	15642-9505
Country	:	US
Telephone Number	:	412-734-2529
Fax Number	:

Provider Business Practice Location Address
First Line	:	12280 STATE ROUTE 30
Second Line	:
City	:	NORTH HUNTINGDON
State	:	PA
Zip	:	15642-1820
Country	:	US
Telephone Number	:	724-863-2000
Fax Number	:	724-863-3599

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	03/05/2024

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