Provider Demographics
NPI:1437148293
Name:HAMZE, OMAR O (MD)
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:O
Last Name:HAMZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2743 SUMMER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-2858
Mailing Address - Country:US
Mailing Address - Phone:901-382-5256
Mailing Address - Fax:901-382-3731
Practice Address - Street 1:2743 SUMMER OAKS DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2858
Practice Address - Country:US
Practice Address - Phone:901-382-5256
Practice Address - Fax:901-382-3731
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38040174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN38912782OtherMEDICARE PTAN
TN1511491Medicaid
TN1511491Medicaid