Healthcare Provider Details

I. General information

NPI: 1467406892
Provider Name (Legal Business Name): LYNDA HAMMOND MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 WILDWOOD AVE SUITE B
JACKSON MI
49201-1044
US

IV. Provider business mailing address

517 WILDWOOD AVE SUITE B
JACKSON MI
49201-1044
US

V. Phone/Fax

Practice location:
  • Phone: 517-782-1500
  • Fax: 517-782-1308
Mailing address:
  • Phone: 517-782-1500
  • Fax: 517-782-1308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number4301065180
License Number StateMI

VIII. Authorized Official

Name: DR. LYNDA CATHERINE HAMMOND
Title or Position: MD
Credential: MD
Phone: 517-782-1500