Provider Demographics
NPI:1023075660
Name:HAMM, JOHN T (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:HAMM
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 1:315 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1703
Mailing Address - Country:US
Mailing Address - Phone:502-272-5754
Mailing Address - Fax:502-272-5339
Practice Address - Street 1:315 E BROADWAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1703
Practice Address - Country:US
Practice Address - Phone:502-629-2500
Practice Address - Fax:502-629-3166
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY22818207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1050401OtherPASSPORT PROVIDER NUMB
KY2527651OtherCIGNA PROVIDER NUMB
KY4045190OtherAETNA PROVIDER NUMB
KY64228182Medicaid
KY000000044826OtherANTHEM PROVIDER NUMB
KY110089561OtherRAILROAD MEDICARE
IN200042640Medicaid
KY000020583COtherHUMANA PROVIDER NUMB
KYC69090Medicare UPIN
KY2527651OtherCIGNA PROVIDER NUMB
IN129980CMedicare PIN
KY0299003Medicare PIN