Provider Demographics
NPI:1831295807
Name:HAMNER, DABNEY J JR (MD)
Entity Type:Individual
Prefix:
First Name:DABNEY
Middle Name:J
Last Name:HAMNER
Suffix:JR
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 1:1211 UNION AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4240 BETHEL RD STE 101
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-8737
Practice Address - Country:US
Practice Address - Phone:662-932-9544
Practice Address - Fax:662-932-9554
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26650207V00000X
MS12119207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ008478Medicaid
MS00115267Medicaid