Healthcare Provider Details

I. General information

NPI: 1740271071
Provider Name (Legal Business Name): JAMES A HAMP MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 MAPLE LN SUITE 2
ASHLAND WI
54806-3768
US

IV. Provider business mailing address

1625 MAPLE LN SUITE 2
ASHLAND WI
54806-3768
US

V. Phone/Fax

Practice location:
  • Phone: 715-682-9311
  • Fax: 715-682-2486
Mailing address:
  • Phone: 715-682-9311
  • Fax: 715-682-2486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number22384
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number22384
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: