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NPI Code Detail

MEDICARE: RICHARD F HAMAKER P.A.

MEDICARE: RICHARD F HAMAKER P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant004567GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1004567OTHERGAGA PHYS ASSISTANT LIC #

General Provider Information

NPI Number : 1104803832
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD F HAMAKER P.A.
Provider Business Mailing Address
First Line : PO BOX 307
Second Line :
City : CUMMING
State : GA
Zip : 30028-0307
Country : US
Telephone Number : 770-887-1668
Fax Number : 770-781-9937
Provider Business Practice Location Address
First Line : 220 OAKSIDE LN
Second Line :
City : CANTON
State : GA
Zip : 30114-6413
Country : US
Telephone Number : 678-807-1050
Fax Number : 678-807-1055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2005
Last Update Date : 10/06/2011

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