Provider Demographics
NPI:1033205679
Name:HAMO NEUROLOGY CLINIC
Entity Type:Organization
Organization Name:HAMO NEUROLOGY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:E
Authorized Official - Last Name:TAUNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-249-0091
Mailing Address - Street 1:1263 TALLADEGA HWY
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-1604
Mailing Address - Country:US
Mailing Address - Phone:256-249-0091
Mailing Address - Fax:256-249-0024
Practice Address - Street 1:1263 TALLADEGA HWY
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-1604
Practice Address - Country:US
Practice Address - Phone:256-249-0091
Practice Address - Fax:256-249-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL190112084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529908170Medicaid
AL051500124Medicare ID - Type Unspecified
AL529908170Medicaid