Organization
ELITE PEDIATRIC AND ADOLESCENT MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRICK RUSH HAMILTON M.D. (OWNER)
(901) 813-8861
Entity
Organization
Contact information
Practice address
214 LAKEVIEW RD, SUITE 2, SOMERVILLE, TN 38068-9737
(901) 516-4082
(901) 516-4092
Mailing address
PO BOX 538, SOMERVILLE, TN 38068-0538
(901) 813-8861
(901) 813-8862
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
38455
TN
Other
Enumeration date
08/20/2010
Last updated
04/09/2026
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