Provider Demographics
NPI:1902800659
Name:HAMILTON, THOMAS K (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:K
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 S MAIN ST LOWR 3
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64801-4521
Mailing Address - Country:US
Mailing Address - Phone:417-781-6722
Mailing Address - Fax:417-781-2090
Practice Address - Street 1:1027 S MAIN ST LOWR 3
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64801-4521
Practice Address - Country:US
Practice Address - Phone:417-781-6722
Practice Address - Fax:417-781-2090
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7766207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200728220AMedicaid
MO240738104Medicaid
MO8718OtherBLUE CHOICE
MOMA2082197Medicare PIN
MO8718OtherBLUE CHOICE