Provider Demographics
NPI:1760412118
Name:HAMAR, DENISE M (DO)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:M
Last Name:HAMAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1221 OAK ST.
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-3059
Mailing Address - Country:US
Mailing Address - Phone:417-359-9291
Mailing Address - Fax:417-359-9241
Practice Address - Street 1:1221 OAK ST.
Practice Address - Street 2:CARTHAGE CHILDREN'S CLINIC, LLC
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-3059
Practice Address - Country:US
Practice Address - Phone:417-359-9291
Practice Address - Fax:417-359-9241
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2010-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR7F62208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO242277424Medicaid
MO26666OtherANTHEM
A10727Medicare UPIN