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Individual

DR. GREGORY TODD HAMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
27015 JESS MORGAN RD, ROLAND, AR 72135-9016
(501) 552-2650
(501) 552-4298
Mailing address
27015 JESS MORGAN RD, ROLAND, AR 72135-9016
(501) 552-2650
(501) 552-4298

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
100875
WI
207P00000X
Emergency Medicine Physician
2005035772
MO
207P00000X
Emergency Medicine Physician
5101013518
MI
207P00000X
Emergency Medicine Physician
Primary
E-6704
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1000099600G
KANSAS MEDICAID HCFA1500
KS
01
200266700B
MEDICAID
KS
01
200369760A
MEDICAID
KS
01
204642102
MEDICAID
MO
05
243419306
MO
01
G85352
BLUE CROSS BLUE SHIELD
KS
01
G85352
BLUE CROSS BLUE SHIELD
MO
Enumeration date
06/07/2006
Last updated
03/25/2024
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