Provider Demographics
NPI:1700087491
Name:HAM, OSCAR EMERSON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:EMERSON
Last Name:HAM
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9000 FERGUSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-6361
Mailing Address - Country:US
Mailing Address - Phone:912-352-3913
Mailing Address - Fax:912-352-2238
Practice Address - Street 1:4 JACKSON BOULEVARD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5810
Practice Address - Country:US
Practice Address - Phone:912-355-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA105562084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00016354AMedicaid
GA00016354AMedicaid