Individual
HAMILTON FREDRICK STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-3376
(601) 579-5240
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-3376
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10507532-1206
UT
363A00000X
Physician Assistant
Primary
PA00383
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04974282
—
MS
Enumeration date
09/06/2017
Last updated
07/28/2020
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