MEDICARE: BRAD HAMMERS

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1184173528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRAD HAMMERS

Provider Business Mailing Address
First Line	:	5000 BACK SQUARE DR
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-7411
Country	:	US
Telephone Number	:	270-685-5500
Fax Number	:	270-685-5565

Provider Business Practice Location Address
First Line	:	5000 BACK SQUARE DR
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-7411
Country	:	US
Telephone Number	:	270-685-5500
Fax Number	:	270-685-5565

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2016
Last Update Date	:	09/27/2016

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