# COASTAL FOOT CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790943017
- **Authorized official:** DR. VALENTINE T HAMILTON DPM (OWNER)
- **Authorized official phone:** (910) 938-6000

## Contact information

- **Practice address:** 217 STATION ST, JACKSONVILLE, NC 28546-6304
- **Practice address phone:** (910) 938-6000
- **Practice address fax:** (910) 938-3618
- **Mailing address:** 217 STATION ST, JACKSONVILLE, NC 28546-6304
- **Mailing address phone:** (910) 938-6000
- **Mailing address fax:** (910) 938-3618

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 222 | NC | Yes |

## Other

- **Enumeration date:** 05/23/2008
- **Last updated:** 09/16/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 08055 | BCBS PIN | — |
| 01 | — | 261QP1100X | MEDICARE NPI TYPE1 | — |
| 05 | — | 8908055 | — | NC |