Healthcare Provider Details

I. General information

NPI: 1295473809
Provider Name (Legal Business Name): HAMMOND SURGICAL HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2022
Last Update Date: 05/24/2022
Certification Date: 05/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19184 DR JOHN LAMBERT DR STE A
HAMMOND LA
70403-0935
US

IV. Provider business mailing address

42570 S AIRPORT RD
HAMMOND LA
70403-0946
US

V. Phone/Fax

Practice location:
  • Phone: 985-542-7766
  • Fax: 985-542-1754
Mailing address:
  • Phone: 985-510-6200
  • Fax: 985-510-6202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: JULIE DIODENE
Title or Position: CHIEF NURSING OFFICER
Credential:
Phone: 985-510-6200