Provider Demographics
NPI:1235336777
Name:HAMMONDS, KATHLEEN HOLLIS (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:HOLLIS
Last Name:HAMMONDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:HOLLIS
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-923-9604
Mailing Address - Fax:757-539-6237
Practice Address - Street 1:2000 MEADE PKWY STE 190
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4259
Practice Address - Country:US
Practice Address - Phone:757-923-9604
Practice Address - Fax:757-539-6237
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301111818207RC0200X
VA0116019609390200000X
VA0101247625207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program