Provider Demographics
NPI:1083058168
Name:HAMM, MATTHEW SCOTT (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:SCOTT
Last Name:HAMM
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72D MEDICAL GROUP/SGHQ
Mailing Address - Street 2:7050 AIR DEPOT BLVD.
Mailing Address - City:TINKER AFB
Mailing Address - State:OK
Mailing Address - Zip Code:73145
Mailing Address - Country:US
Mailing Address - Phone:405-582-6052
Mailing Address - Fax:405-736-3860
Practice Address - Street 1:16205 N PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-7325
Practice Address - Country:US
Practice Address - Phone:405-705-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-19
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT59162083X0100X, 208D00000X
OK357282083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice