Provider Demographics
NPI:1235101619
Name:HAMM, BRIAN L (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:L
Last Name:HAMM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 N. 5TH ST.
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501
Mailing Address - Country:US
Mailing Address - Phone:309-663-6461
Mailing Address - Fax:
Practice Address - Street 1:804 KENYON RD
Practice Address - Street 2:STE 310
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501
Practice Address - Country:US
Practice Address - Phone:515-302-8700
Practice Address - Fax:515-302-8698
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00672213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI3345Medicare PIN
U62822Medicare UPIN