Basic Information
| Provider Information | |||||||||
| NPI: | 1487631289 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMILTON | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | LEMAR | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PA-C, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1650 COCHRANE CIR | ||||||||
| Address2: | BLDG 7505 | ||||||||
| City: | FORT CARSON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809134613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195262092 | ||||||||
| FaxNumber: | 7195267732 | ||||||||
| Practice Location | |||||||||
| Address1: | 1650 COCHRANE CIR | ||||||||
| Address2: | BLDG 7505 | ||||||||
| City: | FORT CARSON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809134613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195262092 | ||||||||
| FaxNumber: | 7195267732 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2005 | ||||||||
| LastUpdateDate: | 02/03/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 1033611 | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 011211-1 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.