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Individual

THOMAS J HAMMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1209 N JACOB ALLCOTT WAY, NAMPA, ID 83687
(208) 461-8700
(208) 461-8705
Mailing address
1209 N JACOB ALLCOTT WAY, NAMPA, ID 83687
(208) 461-8700
(208) 461-8705

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M6666
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010005678
BLUE SHIELD
ID
01
000010005679
BLUE SHIELD
ID
01
000010135658
BLUE SHIELD
ID
01
33191
BLUE CROSS
ID
01
33266
BLUE CROSS
ID
01
46151
BLUE CROSS
ID
05
805527400
ID
01
80635330
HEALTHY CONNECTIONS
ID
Enumeration date
10/24/2005
Last updated
01/03/2013
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