Individual
MATTHEW HAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1918 S. ARKANSAS STREET, SPRINGHILL, LA 71075
(318) 277-2581
Mailing address
1421 LAFAYETTE 5, LEWISVILLE, AR 71845-8678
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
320663
LA
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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