Basic Information
| Provider Information | |||||||||
| NPI: | 1457745929 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAMILTON | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | KYLE | ||||||||
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| Credential: | M.D., M.SC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40 N GRAND AVE | ||||||||
| Address2: | STE 101 | ||||||||
| City: | FORT THOMAS | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410751765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134758400 | ||||||||
| FaxNumber: | 5134758228 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 N GRAND AVE | ||||||||
| Address2: | STE 101 | ||||||||
| City: | FORT THOMAS | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410751765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134758400 | ||||||||
| FaxNumber: | 5134758228 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2015 | ||||||||
| LastUpdateDate: | 01/19/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YX0602X | 53608 | KY | N | Allopathic & Osteopathic Physicians | Otolaryngology | Otolaryngic Allergy | 207Y00000X | 53608 | KY | Y | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | 57.026247 | OH | N | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.