Individual
MR. RUDY GARY HAMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1559 HIGHLAND PARK DR, LENOIR CITY, TN 37772-6237
(865) 635-8389
(865) 635-8390
Mailing address
1559 HIGHLAND PARK DR, LENOIR CITY, TN 37772-6237
(865) 635-8389
(656) 358-3908
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA0000000203TN
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3669684
—
TN
Enumeration date
07/28/2005
Last updated
04/25/2020
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