Healthcare Provider Details

I. General information

NPI: 1518039643
Provider Name (Legal Business Name): DR. ANTHONY W. HAMM, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 PARKWAY DR SUITE B
GOLDSBORO NC
27534-3477
US

IV. Provider business mailing address

1100 PARKWAY DR SUITE B
GOLDSBORO NC
27534-3477
US

V. Phone/Fax

Practice location:
  • Phone: 919-751-1155
  • Fax: 919-751-1151
Mailing address:
  • Phone: 919-751-1155
  • Fax: 919-751-1151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number111NX0800X
License Number StateNC

VIII. Authorized Official

Name: DR. ANTHONY W HAMM
Title or Position: CHIROPRACTIC ORTHOPEDIST
Credential: DC, FACO
Phone: 919-751-1155