Provider Demographics
NPI:1518425941
Name:HAMM, BLACKSTOCK & STERN, PLLC
Entity Type:Organization
Organization Name:HAMM, BLACKSTOCK & STERN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-608-0933
Mailing Address - Street 1:PO BOX 1000 DEPT #3032
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-3032
Mailing Address - Country:US
Mailing Address - Phone:731-608-0933
Mailing Address - Fax:
Practice Address - Street 1:2135 DALKEITH DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38139-3407
Practice Address - Country:US
Practice Address - Phone:731-616-4099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty