Provider Demographics
NPI:1518039643
Name:DR. ANTHONY W. HAMM, PA
Entity Type:Organization
Organization Name:DR. ANTHONY W. HAMM, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC ORTHOPEDIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:W
Authorized Official - Last Name:HAMM
Authorized Official - Suffix:
Authorized Official - Credentials:DC, FACO
Authorized Official - Phone:919-751-1155
Mailing Address - Street 1:1100 PARKWAY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-3477
Mailing Address - Country:US
Mailing Address - Phone:919-751-1155
Mailing Address - Fax:919-751-1151
Practice Address - Street 1:1100 PARKWAY DR
Practice Address - Street 2:SUITE B
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-3477
Practice Address - Country:US
Practice Address - Phone:919-751-1155
Practice Address - Fax:919-751-1151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC111NX0800X111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08470OtherBCBS
NC8908470Medicaid
NC244281Medicare PIN
NC8908470Medicaid