Provider Demographics
NPI:1245296714
Name:HAMBY, ANTHONY FRANK (RT)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:FRANK
Last Name:HAMBY
Suffix:
Gender:M
Credentials:RT
Other - Prefix:MR
Other - First Name:ANTHONY
Other - Middle Name:F
Other - Last Name:HAMBY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:115 HIDDEN OAKS TRL NE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-7320
Mailing Address - Country:US
Mailing Address - Phone:423-336-1555
Mailing Address - Fax:423-336-5415
Practice Address - Street 1:115 HIDDEN OAKS TRL NE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-7320
Practice Address - Country:US
Practice Address - Phone:423-336-1555
Practice Address - Fax:423-336-5415
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000628171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0349020001Medicare NSC