Provider Demographics
NPI:1073593091
Name:HEMMERT, JEROME K (MD)
Entity Type:Individual
Prefix:DR
First Name:JEROME
Middle Name:K
Last Name:HEMMERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:561-570-5172
Mailing Address - Fax:786-472-5770
Practice Address - Street 1:227 W KLEBERG AVE
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-4427
Practice Address - Country:US
Practice Address - Phone:361-592-6451
Practice Address - Fax:361-595-4545
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH3070207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1558464946Medicaid
TX085764101Medicaid
TX085764101Medicaid