=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821330895
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHAWN MICHAEL HAMM MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2013
-----------------------------------------------------
Last Update Date | 04/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6630 SUMMER KNOLL CIR
-----------------------------------------------------
City | BARTLETT
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38134-2875
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-746-9438
-----------------------------------------------------
Fax | 901-746-9331
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 965 RIDGE LAKE BLVD STE 315
-----------------------------------------------------
City | MEMPHIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38120-9401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-348-1281
-----------------------------------------------------
Fax | 901-227-3206
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 53238
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207QA0401X
-----------------------------------------------------
Taxonomy Name | Addiction Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number | 53238
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------