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General NPI Number Information
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NPI Number | 1174800213
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Entity Type | Organization
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Legal Business Name | JEFFREY S. HAMMER, M.D., LLC
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Dates
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Enumeration Date | 11/03/2011
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Last Update Date | 03/11/2012
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Provider Practice Location Address
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Address Line | 315 N MAIN ST SUITE 2
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-1637
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Country | US
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Telephone | 618-656-1726
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Fax |
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Provider Business Mailing Address
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Address Line | 315 N MAIN ST SUITE 2
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-1637
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Country | US
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Telephone | 618-307-5922
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. JEFFREY S HAMMER
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Credential | M.D.
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Telephone | 618-656-1726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036.063661
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License Number State | IL
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