MEDICARE: REBECCA DAWN HAMMOND M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD39802	TN
2	207Q00000X	Family Medicine Physician	37032	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00175090	OTHER	GA	RR MEDICARE PIN
3	CB5773	OTHER	GA	RR MEDICARE GRP
4	4000501	OTHER	KY	MEDICARE LAB GRP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770656456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA DAWN HAMMOND M.D.

Provider Business Mailing Address
First Line	:	140 NEWCOMB AVE
Second Line	:
City	:	MOUNT VERNON
State	:	KY
Zip	:	40456-2725
Country	:	US
Telephone Number	:	606-256-4148
Fax Number	:	606-256-5191

Provider Business Practice Location Address
First Line	:	140 NEWCOMB AVE
Second Line	:
City	:	MOUNT VERNON
State	:	KY
Zip	:	40456-2725
Country	:	US
Telephone Number	:	606-256-4148
Fax Number	:	606-256-5191

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/21/2022

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Directions to “ REBECCA DAWN HAMMOND M.D.” Practice Location

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