Healthcare Provider Details

I. General information

NPI: 1851334452
Provider Name (Legal Business Name): DANIEL JAY HAMMON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 11/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5848 S 300 E SUITE 120
MURRAY UT
84107-6121
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-314-4900
  • Fax: 801-314-4919
Mailing address:
  • Phone: 801-314-4900
  • Fax: 801-314-4919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number2707971205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number270797-1205
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number270797-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: