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General NPI Number Information
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NPI Number | 1306464169
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Entity Type | Individual
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Provider Name | TAMMAM HANNA MD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2020
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 2500 NORTH STATE STREET
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City | JACKSON
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State | MS
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Zip | 39216
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Country | US
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Telephone | 601-984-1041
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Fax | 601-984-5151
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Provider Business Mailing Address
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Address Line | 2500 NORTH STATE STREET
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City | JACKSON
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State | MS
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Zip | 39216
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Country | US
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Telephone | 601-984-1041
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Fax | 601-984-5151
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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 | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | T-4505
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | T-4505
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | MT220162
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | T-4505
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License Number State | MS
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