Healthcare Provider Details

I. General information

NPI: 1407841539
Provider Name (Legal Business Name): HOWARD MARC HAMMER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 CRESTVIEW PARK DR STE 2
DICKSON TN
37055-2853
US

IV. Provider business mailing address

127 CRESTVIEW PARK DR STE 209
DICKSON TN
37055-2856
US

V. Phone/Fax

Practice location:
  • Phone: 615-446-1370
  • Fax: 615-560-5998
Mailing address:
  • Phone: 615-446-5121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberOS009577L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: