Healthcare Provider Details

I. General information

NPI: 1952315624
Provider Name (Legal Business Name): BYRON ALLEN HAMMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 06/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 WESTBANK EXPRESSWAY
MARRERO LA
70072
US

IV. Provider business mailing address

5001 WESTBANK EXPY
MARRERO LA
70072-2954
US

V. Phone/Fax

Practice location:
  • Phone: 504-349-8708
  • Fax: 504-329-8703
Mailing address:
  • Phone: 504-349-8755
  • Fax: 504-349-8768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberR015279 / L12835R
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR015279 / L12835R
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberR015279 / L12835R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: