HAMILTON MEDICAL CENTE PHYSICIAN (NPI# 1790975449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790975449 |
| Entity Type | Organization |
| Organization Name | HAMILTON MEDICAL CENTE PHYSICIAN |
| Practice Address |
1200 Memorial Dr Dalton GA 30720-2529 |
| Practice Telephone | 7062726560 |
| Practice Fax Number | 7062726562 |
| Mailing Telephone | 7062726560 |
| Mailing Fax Number | 7062726562 |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2008-05-23 |
| Authorized Official Name | MR. MIKE STEIN (DIRECTOR) |
| Authorized Official Telephone | 7062726000 |
| Is Organization Subpart | Y |
| Parent Organization Name | HAMILTON MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
CSW002516 | GA | Behavioral Health & Social Service Providers |
| N | 208100000X | Physical Medicine & Rehabilitation | 49851 | GA | Allopathic & Osteopathic Physicians |
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
49851 | GA | Allopathic & Osteopathic Physicians |
| Y | 2084F0202X |
Psychiatry & Neurology Specialization: Forensic Psychiatry |
057776 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1200 MEMORIAL DR |
| City | DALTON |
| State | GA |
| Zip Code | 30720-2529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710982103 | Paul Crutchfield | Specialist | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2005-06-14 |
| 1891395505 | Molly Van Wert Cooper | Registered Nurse | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-10-30 |
| 1922608116 | William Saunders IIi | Nurse Anesthetist, Certified Registered | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-10-28 |
| 1114545431 | North Georgia Anesthesia Services PC | Anesthesiology | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-07-13 |
| 1326665100 | Lacey Boutwell | Pharmacist | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-06-29 |
| 1265061816 | Kiranjit Singh | Student in an Organized Health Care Education/Training Program | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-04-06 |
| 1215566864 | Katelyn Amanda Boykin | Student in an Organized Health Care Education/Training Program | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-04-06 |
| 1851920409 | Bradley Sackfield | Student in an Organized Health Care Education/Training Program | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-04-06 |
| 1619506557 | Kenette St-gourdin | Student in an Organized Health Care Education/Training Program | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-04-03 |
| 1699304790 | Tomislav Hrvoje Jagatic | Student in an Organized Health Care Education/Training Program | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528688421 | Nighat Purnima Kabir | Student in an Organized Health Care Education/Training Program | Hamilton Medical Center, Attn: Residency Program, 1200 Memorial Drive, Dalton, GA 30720 | 2020-04-21 |
| 1720620727 | Elizabeth Nicole Gregory | Behavioral Analyst | 1201 Burleyson Rd., Dalton, GA 30720 | 2019-10-10 |
| 1972161768 | Andrea Nicole Henry | Speech-Language Pathologist | 1201 Burleyson Road, Dalton, Ga. 30720, Dalton, GA 30720 | 2019-06-05 |
| 1275056905 | Cynthia L Wood | Speech-Language Pathologist | 1011 Professional Blvd., Dalton, GA 30720 | 2017-07-25 |
| 1073069225 | Alyssa Sellers Garner | Nurse Practitioner | 1436 Chattanooga Avenue, Dalton, GA 30720 | 2016-08-28 |
| 1588039077 | Katie Walker | Social Worker | 900 Shugart Road, Dalton, GA 30720 | 2015-12-09 |
| 1215310800 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 98 West Walnut Ave, Dalton, GA 30720 | 2015-07-01 |
| 1275969081 | Stacy Kay Whitehead | Nurse Practitioner | 1411 Chattanooga Avenue, Suite 101, Dalton, GA 30720 | 2013-09-25 |
| 1821439985 | Chantal Aneka Raheeda Lewis | Internal Medicine | 1109 Burleyson Rd Ste 103, Dalton, GA 30720 | 2013-07-17 |
| 1174960678 | Homestead Hospice of Northwest Georgia, LLC | Hospice Care, Community Based | 1601 Hickory Street, Dalton, GA 30720 | 2013-05-24 |
| Find all providers in zip 30720 | ||||
| Taxonomy Code | 2084F0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Forensic Psychiatry |
| Forensic Psychiatry is a subspecialty with psychiatric focus on interrelationships with civil, criminal and administrative law, evaluation and specialized treatment of individuals involved with the legal system, incarcerated in jails, prisons, and forensic psychiatry hospitals. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922668169 | Lufti I Yargic | Psychiatry & Neurology | Csh - Cook Building 2450 Vinson Highway, Milledgeville, GA 31062-0001 | 2019-06-19 |
| 1124334545 | Michael Clark Hilton | Psychiatry & Neurology | 3975 Roswell Rd, Atlanta, GA 30342-4119 | 2010-08-23 |
| 1760616858 | Bryon Mcquirt | Psychiatry & Neurology | 48 Main St Ste 2a, Senoia, GA 30276-1895 | 2009-05-05 |
| 1972713998 | Julie Rand Dorney | Psychiatry & Neurology | 3500 Piedmont Rd Ne Ste 775, Atlanta, GA 30305-1520 | 2007-05-22 |
| 1205952231 | Shaw Wendi Fortuchang | Psychiatry & Neurology | 110 N Park Dr, Fayetteville, GA 30214-1645 | 2007-03-21 |
| 1871643890 | Angela P. Shannon Md PC | Psychiatry & Neurology | 1129 Hospital Dr, Suite 3c, Stockbridge, GA 30281-6393 | 2007-01-11 |
| 1962572511 | Thomas H Sachy | Psychiatry & Neurology | 247 Lana Drive, Gray, GA 31032 | 2006-11-09 |
| 1285717942 | Deepti Jain Bhasin | Psychiatry & Neurology | 402 Osigian Blvd, Sutie 400, Warner Robins, GA 31088-8988 | 2006-10-23 |
| 1376631861 | Velda Jean Givens | Psychiatry & Neurology | 3537 Macon Rd, Suite 5, Columbus, GA 31907 | 2006-10-10 |
| 1285735852 | Ashley A. Thompson | Psychiatry & Neurology | 55 Carlton Street, Athens, GA 30602-1503 | 2006-09-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.