Individual
MR. DUSTIN T HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 ABRAHAM FLEXNER WAY, LOUISVILLE, KY 40202-2877
(502) 587-4421
(502) 587-4840
Mailing address
5454 NEW CUT RD, STE 5, LOUISVILLE, KY 40214-4271
(502) 361-9900
(502) 955-3383
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
40403
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000057678
ANTHEM
KY
05
—
200851120
—
IN
01
—
2711347000
PASSPORT ADVANTAGE
KY
01
—
50010525
PASSPORT
KY
05
—
64094238
—
KY
01
—
P00303970
RAILROAD MEDICARE
KY
Enumeration date
05/23/2006
Last updated
02/06/2017
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