Provider Demographics
NPI:1821089244
Name:COMPREHENSIVE HEALTH - J HAMNER MD PC
Entity Type:Organization
Organization Name:COMPREHENSIVE HEALTH - J HAMNER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEWELL
Authorized Official - Middle Name:S
Authorized Official - Last Name:HAMNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD MBA
Authorized Official - Phone:334-875-2266
Mailing Address - Street 1:PO BOX 545
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36702-0545
Mailing Address - Country:US
Mailing Address - Phone:334-875-2266
Mailing Address - Fax:334-875-2277
Practice Address - Street 1:1013 MEDICAL CENTER PKWY
Practice Address - Street 2:FRIST - HOWELL BUILDING II
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-6742
Practice Address - Country:US
Practice Address - Phone:334-875-2266
Practice Address - Fax:334-875-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052071207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E77771Medicare UPIN
ON66070Medicare ID - Type Unspecified