MEDICARE: TONY L HAM M.D.

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	207Q00000X	Family Medicine Physician	150284	MA

General Provider Information

NPI Number	:	1760555908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONY L HAM M.D.

Provider Business Mailing Address
First Line	:	340 DEER PATH
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718-7674
Country	:	US
Telephone Number	:	406-763-5254
Fax Number	:

Provider Business Practice Location Address
First Line	:	340 DEER PATH
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718-7674
Country	:	US
Telephone Number	:	406-763-5254
Fax Number	:

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	12/09/2025

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