Provider Demographics
NPI:1306837315
Name:HAMMOND, MARILYNN K (MD)
Entity Type:Individual
Prefix:
First Name:MARILYNN
Middle Name:K
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 AZALEA RD
Mailing Address - Street 2:ONE OFFICE PARK SUITE 302
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-1970
Mailing Address - Country:US
Mailing Address - Phone:251-343-3888
Mailing Address - Fax:251-343-3565
Practice Address - Street 1:273 AZALEA RD
Practice Address - Street 2:ONE OFFICE PARK SUITE 302
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-1970
Practice Address - Country:US
Practice Address - Phone:251-343-3888
Practice Address - Fax:251-343-3565
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN323922084P0800X
ALAL000230362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
149053OtherVALUE OPTS
51522461OtherBCBS OF AL
240539OtherCOMPSYCH
AL051522461Medicare ID - Type Unspecified
149053OtherVALUE OPTS