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General NPI Number Information
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NPI Number | 1033215017
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Entity Type | Individual
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Provider Name | JACK L HAMMAN MD
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Gender | Male
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 12/04/2020
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Provider Practice Location Address
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Address Line | 800 HOSPITAL DR
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City | MADISONVILLE
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State | KY
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Zip | 42431-1658
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Country | US
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Telephone | 270-326-3800
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Fax | 270-326-3805
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Provider Business Mailing Address
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Address Line | 200 CLINIC DR
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City | MADISONVILLE
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State | KY
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Zip | 42431-1661
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 14714
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 14714
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 14714
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License Number State | KY
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