Individual
JORDAN T HAMMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1951 BENCH RD STE B, POCATELLO, ID 83201-2073
(208) 238-1000
Mailing address
1951 BENCH RD, POCATELLO, ID 83201-2013
(208) 238-1000
(208) 238-0009
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MRO-2043
ID
Other
Enumeration date
05/24/2021
Last updated
08/07/2024
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