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General NPI Number Information
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NPI Number | 1720045305
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Entity Type | Individual
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Provider Name | DAVID B HAMMACK MD
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Gender | Male
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 02/17/2010
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Provider Practice Location Address
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Address Line | 762 ROUTE 3 SUITE 14
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City | PLATTSBURGH
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State | NY
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Zip | 12901-7472
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Country | US
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Telephone | 518-562-3204
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Fax | 518-563-0707
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Provider Business Mailing Address
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Address Line | 11 LEXINGTON AVE
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City | PLATTSBURGH
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State | NY
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Zip | 12901-2513
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Country | US
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Telephone | 518-563-6834
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 1158201
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License Number State | NY
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