Provider Demographics
NPI:1467406892
Name:LYNDA HAMMOND MD PLLC
Entity Type:Organization
Organization Name:LYNDA HAMMOND MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-782-1500
Mailing Address - Street 1:517 WILDWOOD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1044
Mailing Address - Country:US
Mailing Address - Phone:517-782-1500
Mailing Address - Fax:517-782-1308
Practice Address - Street 1:517 WILDWOOD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1044
Practice Address - Country:US
Practice Address - Phone:517-782-1500
Practice Address - Fax:517-782-1308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065180207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5243763Medicaid