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General NPI Number Information
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NPI Number | 1083058168
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Entity Type | Individual
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Provider Name | MATTHEW SCOTT HAMM MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 04/19/2013
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 16205 N PENNSYLVANIA AVE
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City | EDMOND
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State | OK
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Zip | 73013-7325
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Country | US
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Telephone | 405-705-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 72D MEDICAL GROUP/SGHQ 7050 AIR DEPOT BLVD.
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City | TINKER AFB
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State | OK
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Zip | 73145
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Country | US
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Telephone | 405-582-6052
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Fax | 405-736-3860
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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 | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | T5916
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | T5916
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 35728
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License Number State | OK
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