Provider Demographics
NPI:1760412209
Name:HAMBY, ANDREW L (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:L
Last Name:HAMBY
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:#1 CHILDREN'S WAY, SLOT 844
Mailing Address - Street 2:ACMG
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-2090
Mailing Address - Fax:501-364-3929
Practice Address - Street 1:2601 GENE GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0845
Practice Address - Country:US
Practice Address - Phone:479-725-6880
Practice Address - Fax:479-725-6582
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV0415208000000X
MO2003020131208000000X
ARE-9583208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209083005Medicaid
AR215364001Medicaid
OK200014340AMedicaid
KS100643070AMedicaid
MO181341OtherANTHEM
KS100643070AMedicaid