Provider Demographics
NPI:1295754950
Name:HAMM, JOSEPH LYNDON (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LYNDON
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 1:1936 OLD ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2247
Mailing Address - Country:US
Mailing Address - Phone:205-978-3200
Mailing Address - Fax:205-978-5745
Practice Address - Street 1:1936 OLD ORCHARD RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-2247
Practice Address - Country:US
Practice Address - Phone:205-978-3200
Practice Address - Fax:205-978-5745
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11576208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51030024OtherBLUE CROSS PROVIDER
AL630307306015OtherTRICARE PROVIDER NUMBER
ALF936OtherBLUE CROSS COMMON PAYER
AL000030024Medicaid
AL0004006100OtherAETNA PROVIDER NUMBER
AL90703OtherCIGNA PROVIDER NUMBER
AL529701610Medicaid
AL1210164OtherUNITED HEALTHCARE PROVIDE
AL90703OtherCIGNA PROVIDER NUMBER
ALF936OtherBLUE CROSS COMMON PAYER
AL529701610Medicaid