MEDICARE: DR. THOMAS K 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	207Q00000X	Family Medicine Physician	R7766	MO

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8718	OTHER	MO	BLUE CHOICE

General Provider Information

NPI Number	:	1902800659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS K HAMILTON D.O.

Provider Business Mailing Address
First Line	:	1027 S MAIN ST LOWR 3
Second Line	:
City	:	JOPLIN
State	:	MO
Zip	:	64801-4521
Country	:	US
Telephone Number	:	417-781-6722
Fax Number	:	417-781-2090

Provider Business Practice Location Address
First Line	:	1027 S MAIN ST LOWR 3
Second Line	:
City	:	JOPLIN
State	:	MO
Zip	:	64801-4521
Country	:	US
Telephone Number	:	417-781-6722
Fax Number	:	417-781-2090

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	07/21/2022

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