Provider Demographics
NPI:1629008990
Name:HAMILTON, RYAN T (AUD)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:T
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 STATE ST
Mailing Address - Street 2:
Mailing Address - City:GRAYLING
Mailing Address - State:MI
Mailing Address - Zip Code:49738-1861
Mailing Address - Country:US
Mailing Address - Phone:989-745-6667
Mailing Address - Fax:989-745-6668
Practice Address - Street 1:306 STATE ST
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-1861
Practice Address - Country:US
Practice Address - Phone:989-745-6667
Practice Address - Fax:989-745-6668
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000205237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter