MEDICARE: MR. TOMMY D HAMMONDS PA-C

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	363A00000X	Physician Assistant	5078	TN
2	363A00000X	Physician Assistant	PA19546	CA
3	363AS0400X	Surgical Physician Assistant	5078	TN

General Provider Information

NPI Number	:	1972786879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TOMMY D HAMMONDS PA-C

Provider Business Mailing Address
First Line	:	PO BOX 936535
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-6535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 GLEN ECHO RD STE 111
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2857
Country	:	US
Telephone Number	:	615-657-4805
Fax Number	:

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

Provider Enumeration Date	:	12/13/2007
Last Update Date	:	06/05/2023

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