Provider Demographics
NPI:1750427688
Name:HAMNER, JEWELL (MD,MBA)
Entity type:Individual
Prefix:DR
First Name:JEWELL
Middle Name:
Last Name:HAMNER
Suffix:
Gender:F
Credentials:MD,MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 545
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36702-0545
Mailing Address - Country:US
Mailing Address - Phone:334-875-2266
Mailing Address - Fax:334-875-2277
Practice Address - Street 1:1013 MEDICAL CENTER PKWY
Practice Address - Street 2:FRIST - HOWELL BUILDING II
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-6742
Practice Address - Country:US
Practice Address - Phone:334-875-2266
Practice Address - Fax:334-875-2277
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052071207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION66070Medicare ID - Type Unspecified
MIE77771Medicare UPIN