Provider Demographics
NPI:1447361639
Name:HAMILL, JOHN RICHARD JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RICHARD
Last Name:HAMILL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12812 DEEP SPRING DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2357
Mailing Address - Country:US
Mailing Address - Phone:301-762-5074
Mailing Address - Fax:
Practice Address - Street 1:5454 WISCONSIN AVE
Practice Address - Street 2:STE 675
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6930
Practice Address - Country:US
Practice Address - Phone:301-657-0802
Practice Address - Fax:301-657-0803
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0015159207W00000X
DCMD6020207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D06041Medicare UPIN
MDG01079Medicare ID - Type Unspecified