Healthcare Provider Details

I. General information

NPI: 1710990064
Provider Name (Legal Business Name): DR. ROBERT TODD HAMMONS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 KINGS DAUGHTERS DR STE 204 FRANKFORT
FRANKFORT KY
40601-6562
US

IV. Provider business mailing address

5200 COMMERCE CROSSING 3RD FLOOR
LOUISVILLE KY
40229-2182
US

V. Phone/Fax

Practice location:
  • Phone: 502-875-9885
  • Fax: 502-875-9882
Mailing address:
  • Phone: 502-253-4900
  • Fax: 502-489-5751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number27319
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: