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General NPI Number Information
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NPI Number | 1801150503
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Entity Type | Organization
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Legal Business Name | KEVIN HAMM ,DO,PA
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 06/27/2012
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Provider Practice Location Address
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Address Line | 1323 N A ST
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City | WELLINGTON
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State | KS
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Zip | 67152-4350
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Country | US
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Telephone | 316-755-0482
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Fax | 316-755-0458
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Provider Business Mailing Address
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Address Line | PO BOX 373
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City | ANDOVER
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State | KS
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Zip | 67002-0373
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Country | US
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Telephone | 316-755-0482
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Fax | 316-755-0458
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Authorized Official
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Title or Position | OWNER
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Name | MR. KEVIN HAMM
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Credential | DO
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Telephone | 316-755-0482
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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 | 05-26968
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License Number State | KS
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