Individual
BRYAN HAMMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
167 E 1ST S, RIGBY, ID 83442-1401
(208) 745-8747
(208) 745-9396
Mailing address
167 E 1ST S, RIGBY, ID 83442-1401
(208) 745-8747
(208) 745-9396
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-213
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
O-213
STATE LICENSE
ID
Enumeration date
07/19/2006
Last updated
07/09/2007
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