Hamilton, Derrick Jack

Hamilton, Derrick Jack is an individual health care provider with primary practice located at 1484 Lakeside Drive , Jackson KY 41339-6555. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Hamilton, Derrick Jack can be contacted via phone (606) 666-9950.

Contact Information

Primary practice address
1484 Lakeside Drive Jackson KY 41339-6555
Phone: (606) 666-9950
Fax: (606) 666-9136
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 02998 Kentucky

Profile Details

NPI number 1376631283
LBN Legal business name Hamilton, Derrick Jack
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Mar 13th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376631283 NPPES
Kentucky Other 1407818628 MEDICIAID FQHC GROUP LEE
Kentucky Other 1962823393 MEDICIAID FQHC GROUP LEE
Kentucky MEDICAID 7100015160 MEDICIAID FQHC GROUP LEE
Kentucky Other 1467417691 MEDICIAID FQHC GROUP LEE

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