Healthcare Provider Details

I. General information

NPI: 1841282654
Provider Name (Legal Business Name): CATHY L HAMMOND-MOULTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 BRIARVILLE RD BLDG E
MADISON TN
37115-5136
US

IV. Provider business mailing address

1210 BRIARVILLE RD BLDG E
MADISON TN
37115-5136
US

V. Phone/Fax

Practice location:
  • Phone: 615-860-8182
  • Fax: 615-860-8184
Mailing address:
  • Phone: 615-860-8182
  • Fax: 615-860-8184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD37235
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: