Provider Demographics
NPI:1942229497
Name:HAMILTON, THOMAS LIN IV
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:LIN
Last Name:HAMILTON
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 OLD ROCKFORD ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-5356
Mailing Address - Country:US
Mailing Address - Phone:336-789-9089
Mailing Address - Fax:336-789-1161
Practice Address - Street 1:933 OLD ROCKFORD ST
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-5356
Practice Address - Country:US
Practice Address - Phone:336-789-9089
Practice Address - Fax:336-789-1161
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist