Organization Name: | WILLIAM D HAMMONDS, MD |
NPI Number: | 1093088635 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SCHARA KERBO (VICE PRESIDENT) |
Mailing Address: | 102 Lakeshore Dr Suite C Saint Marys |
State: | GA US |
Postal Code: | 315583874 |
Phone Number: | 9127297229 |
Fax Number: | 9125253190 |
NPI Enumeration Date: | 02/13/2012 |
NPI Last Update Date: | 02/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | 14053 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |