| Doctor Name: | RONALD HAMM |
| NPI Number: | 1003893033 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 085001221 |
| Business Practice Address: | 5108 Cleveland Blvd Caldwell, ID - 836078002 |
| Business Phone Number: | 2084590256 |
| Business Fax Number: | 2084594506 |
| Mailing Address: | 5108 Cleveland Blvd, CALDWELL |
| State: | ID |
| Postal Code: | 836078002 |
| Phone Number: | 2084590256 |
| Fax Number: | 2084594506 |
| NPI Enumeration Date: | 12/30/2005 |
| NPI Last Update Date: | 01/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 085001221 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |