Basic Information
Provider Information
NPI: 1780824227
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMILTON
FirstName: GINGER
MiddleName: FLOWERS
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 102966
Address2:  
City: ATLANTA
State: GA
PostalCode: 303682966
CountryCode: US
TelephoneNumber: 8009191190
FaxNumber: 7067372272
Practice Location
Address1: 1133 EAGLES LANDING PKWY
Address2: ANESTHESIA DEPT.
City: STOCKBRIDGE
State: GA
PostalCode: 302815085
CountryCode: US
TelephoneNumber: 6786041053
FaxNumber: 6786045548
Other Information
ProviderEnumerationDate: 02/24/2009
LastUpdateDate: 02/24/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN166568GAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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