Provider Demographics
NPI:1871116145
Name:HAMILTON, STEPHEN NATHANIEL (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:NATHANIEL
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11751 ALTA VISTA RD STE 203
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6442
Mailing Address - Country:US
Mailing Address - Phone:817-431-5575
Mailing Address - Fax:
Practice Address - Street 1:11751 ALTA VISTA RD STE 203
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6442
Practice Address - Country:US
Practice Address - Phone:817-431-5575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor