Provider Demographics
NPI:1679125140
Name:HAMILTON, ANDREW M (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:M
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 S 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-7246
Mailing Address - Country:US
Mailing Address - Phone:601-261-1650
Mailing Address - Fax:601-579-5240
Practice Address - Street 1:102 MEDICAL PARK STE B
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-9080
Practice Address - Country:US
Practice Address - Phone:601-261-1650
Practice Address - Fax:601-545-1740
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2139103TC0700X
MS601053103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical