Healthcare Provider Details

I. General information

NPI: 1386669679
Provider Name (Legal Business Name): JASON MATHEW HAMMOND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 01/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 HAMMILL LN
RENO NV
89511-2045
US

IV. Provider business mailing address

520 HAMMILL LN
RENO NV
89511-2045
US

V. Phone/Fax

Practice location:
  • Phone: 775-348-1313
  • Fax: 775-348-1798
Mailing address:
  • Phone: 775-348-1313
  • Fax: 775-348-1798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME93090
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA109461
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number15604
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: