Organization
PREMIER FAMILY CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN T HAMILTON DO (PRESIDENT/OWNER)
(918) 258-9990
Entity
Organization
Contact information
Practice address
1130 E LANSING ST, BROKEN ARROW, OK 74012-2016
(918) 258-9990
(918) 251-9339
Mailing address
PO BOX 3500, DEPT 365, CLAREMORE, OK 74018-3500
(918) 258-9990
(918) 251-9339
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3896
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF7430
RAILROAD MEDICARE
OK
Enumeration date
04/20/2006
Last updated
08/19/2010
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