Provider Demographics
NPI:1235201138
Name:HAMES, JOHN D (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:D
Last Name:HAMES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 LEON AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEZUMA
Mailing Address - State:GA
Mailing Address - Zip Code:31063-1322
Mailing Address - Country:US
Mailing Address - Phone:478-472-6609
Mailing Address - Fax:
Practice Address - Street 1:112 S DOOLY ST
Practice Address - Street 2:
Practice Address - City:MONTEZUMA
Practice Address - State:GA
Practice Address - Zip Code:31063
Practice Address - Country:US
Practice Address - Phone:478-472-6609
Practice Address - Fax:478-472-5887
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH008698183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist