Provider Demographics
NPI:1225278914
Name:HAMBY, KENNETH JEROME (DO)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:JEROME
Last Name:HAMBY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:14069 FM 849
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-5160
Mailing Address - Country:US
Mailing Address - Phone:903-590-5263
Mailing Address - Fax:903-590-5261
Practice Address - Street 1:14069 FM 849
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-5160
Practice Address - Country:US
Practice Address - Phone:903-590-5263
Practice Address - Fax:903-590-5261
Is Sole Proprietor?:No
Enumeration Date:2009-02-20
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV9044207Q00000X
MO2019033197207Q00000X
SCDO32953207Q00000X
NC195325207Q00000X
NC2013-02082207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine