Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 54133 | TN |
NPI | 1588984561 |
---|---|
Provider Name | Jared Austin Hamm |
First Address | Knoxville, TN 37901-5004 |
Second Address | Knoxville, TN 37916-2301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2010 |
Last Update Date | 22/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q021166 | (05) | TN |