MEDICARE: DR. KENNETH E HAMILTON D.O.

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	207V00000X	Obstetrics & Gynecology Physician	2005036202	MO
2	207V00000X	Obstetrics & Gynecology Physician	3112	OK

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
2	221288	OTHER	MO	BLUE CROSS

General Provider Information

NPI Number	:	1760462618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH E HAMILTON D.O.

Provider Business Mailing Address
First Line	:	6600 S YALE AVE
Second Line	:	SUITE 1400
City	:	TULSA
State	:	OK
Zip	:	74136-3347
Country	:	US
Telephone Number	:	918-488-6001
Fax Number	:

Provider Business Practice Location Address
First Line	:	6465 S YALE AVE STE 615
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-7808
Country	:	US
Telephone Number	:	918-502-4600
Fax Number	:	918-502-4605

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	01/22/2021

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Directions to “ DR. KENNETH E HAMILTON D.O.” Practice Location

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