Individual
DR. DERRICK JACK HAMILTON
Active
Individual
DR. DERRICK JACK HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02998
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407818628
MEDICIAID FQHC GROUP LEE
KY
01
—
1467417691
MEDICAID FQHC GROUP JACKSON
KY
01
—
1962823393
MEDICIAID FQHC GROUP WOLFE
KY
05
—
7100015160
—
KY
Enumeration date
10/10/2006
Last updated
03/13/2020
Update your record
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