=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467406892
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LYNDA HAMMOND MD PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/20/2006
-----------------------------------------------------
Last Update Date | 01/28/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 517 WILDWOOD AVE SUITE B
-----------------------------------------------------
City | JACKSON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49201-1044
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-782-1500
-----------------------------------------------------
Fax | 517-782-1308
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 517 WILDWOOD AVE SUITE B
-----------------------------------------------------
City | JACKSON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49201-1044
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-782-1500
-----------------------------------------------------
Fax | 517-782-1308
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MD
-----------------------------------------------------
Name | DR. LYNDA CATHERINE HAMMOND
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 517-782-1500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QA0505X
-----------------------------------------------------
Taxonomy Name | Adult Medicine Physician
-----------------------------------------------------
License Number | 4301065180
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------