Individual
DR. JACK FREDERICK HAMILTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2030 WALTON WAY, AUGUSTA, GA 30904-4120
(706) 738-1925
(706) 738-0705
Mailing address
2030 WALTON WAY, AUGUSTA, GA 30904-4120
(706) 738-1925
(706) 738-0705
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD000340
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00005904B
—
GA
01
—
1922914
MEDICARE NSC
GA
01
—
480026649
RAILROAD MEDICARE
GA
01
—
48SCBZS
MEDICARE
GA
01
—
52000361
BLUE CROSS BLUE SHIELD
GA
Enumeration date
02/23/2006
Last updated
05/19/2008
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