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Individual

DERON JOHN HAMMACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
143 BEUHRING ST, LAVALETTE, WV 25535-8706
(304) 525-7272
(304) 525-7272
Mailing address
143 BEUHRING ST, LAVALETTE, WV 25535-8706
(304) 525-7272
(304) 525-7272

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2487
WV
207Q00000X
Family Medicine Physician
Primary
2487
WV
207Q00000X
Family Medicine Physician
TP322
KY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
02/04/2009
Last updated
08/13/2010
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