Provider Demographics
NPI:1063695211
Name:HAMM, ROBERT WARREN (RT(R)(CT))
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:WARREN
Last Name:HAMM
Suffix:
Gender:M
Credentials:RT(R)(CT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 SMITHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:TELLICO PLAINS
Mailing Address - State:TN
Mailing Address - Zip Code:37385-5903
Mailing Address - Country:US
Mailing Address - Phone:877-291-4882
Mailing Address - Fax:
Practice Address - Street 1:2995 SMITHFIELD RD
Practice Address - Street 2:
Practice Address - City:TELLICO PLAINS
Practice Address - State:TN
Practice Address - Zip Code:37385-5903
Practice Address - Country:US
Practice Address - Phone:877-291-4882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHT 926682471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography