Provider Demographics
NPI:1194121376
Name:HAMMERSBERG, JON ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:ROBERT
Last Name:HAMMERSBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 SPOTTSWOOD RD
Mailing Address - Street 2:APT 504
Mailing Address - City:STEELES TAVERN
Mailing Address - State:VA
Mailing Address - Zip Code:24476-2002
Mailing Address - Country:US
Mailing Address - Phone:757-778-0815
Mailing Address - Fax:
Practice Address - Street 1:890 SPOTTSWOOD RD
Practice Address - Street 2:APT 504
Practice Address - City:STEELES TAVERN
Practice Address - State:VA
Practice Address - Zip Code:24476-2002
Practice Address - Country:US
Practice Address - Phone:757-778-0815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1010121200207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine