Provider Demographics
NPI:1841234440
Name:HAMM, JOHN F (DPM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:HAMM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 2ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-4008
Mailing Address - Country:US
Mailing Address - Phone:319-364-0297
Mailing Address - Fax:319-364-0298
Practice Address - Street 1:1300 2ND AVE SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-4008
Practice Address - Country:US
Practice Address - Phone:319-364-0297
Practice Address - Fax:319-364-0298
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000320213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0002725Medicaid
IA0002725Medicaid
IAT00002Medicare UPIN