Provider Demographics
NPI:1194190181
Name:HUGH J. HAMMANT
Entity Type:Organization
Organization Name:HUGH J. HAMMANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAMMANT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:530-521-5610
Mailing Address - Street 1:1307 ARNOLD PALMER CT
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-3902
Mailing Address - Country:US
Mailing Address - Phone:585-455-7160
Mailing Address - Fax:
Practice Address - Street 1:1307 ARNOLD PALMER CT
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-3902
Practice Address - Country:US
Practice Address - Phone:585-455-7160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1179103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNMB2502OtherMEDICARE PTAN