MEDICARE: HAMILTON & HAMILTON PC

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	1041C0700X	Clinical Social Worker	34004896A	IN
2	103T00000X	Psychologist	20041611A	IN

General Provider Information

NPI Number	:	1578768925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMILTON & HAMILTON PC

Provider Business Mailing Address
First Line	:	6308 RUCKER RD
Second Line	:	SUITE B
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4887
Country	:	US
Telephone Number	:	317-713-1216
Fax Number	:	317-465-9689

Provider Business Practice Location Address
First Line	:	6308 RUCKER RD
Second Line	:	SUITE B
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4887
Country	:	US
Telephone Number	:	317-713-1216
Fax Number	:	317-465-9689

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. TAMARA KAE HAMILTON
Credential	:	LCSW
Telephone Number	:	317-713-1216

Provider Enumeration Date	:	06/17/2007
Last Update Date	:	07/15/2010

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