Healthcare Provider Details

I. General information

NPI: 1578258661
Provider Name (Legal Business Name): JOHN HAMMOND
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13521 OLD HIGHWAY 280 STE 225
BIRMINGHAM AL
35242-1407
US

IV. Provider business mailing address

3500 BLUE LAKE DR STE 495
VESTAVIA AL
35243-1975
US

V. Phone/Fax

Practice location:
  • Phone: 205-408-4349
  • Fax: 205-408-4225
Mailing address:
  • Phone: 800-257-6570
  • Fax: 205-264-2053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberLL89695
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.54187
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: