Provider Demographics
NPI:1073606067
Name:HAMMER & HACK MDS PLLC
Entity Type:Organization
Organization Name:HAMMER & HACK MDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:HAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-361-1121
Mailing Address - Street 1:4500 CHURCHMAN AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40215
Mailing Address - Country:US
Mailing Address - Phone:502-361-1121
Mailing Address - Fax:502-361-9030
Practice Address - Street 1:4500 CHURCHMAN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215
Practice Address - Country:US
Practice Address - Phone:502-361-1121
Practice Address - Fax:502-361-9030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4171POtherLICENSE
E46547Medicare UPIN
1174803Medicare ID - Type Unspecified
Q06468Medicare ID - Type Unspecified
C71062Medicare UPIN
4171POtherLICENSE