Provider Demographics
NPI:1316032105
Name:HAMMOND, LEE ANN (MD)
Entity Type:Individual
Prefix:
First Name:LEE ANN
Middle Name:
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 1:3230 E WOODMEN RD
Mailing Address - Street 2:STE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-8501
Mailing Address - Country:US
Mailing Address - Phone:719-634-8800
Mailing Address - Fax:719-634-4474
Practice Address - Street 1:3230 E WOODMEN RD
Practice Address - Street 2:STE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-8501
Practice Address - Country:US
Practice Address - Phone:719-634-8800
Practice Address - Fax:719-634-4474
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40949207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO53972554Medicaid
COC803864Medicare PIN
H95341Medicare UPIN
CO510668Medicare ID - Type Unspecified