Provider Demographics
NPI:1710990064
Name:HAMMONS, ROBERT TODD
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:TODD
Last Name:HAMMONS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 COMMERCE CROSSING
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-2182
Mailing Address - Country:US
Mailing Address - Phone:502-253-4900
Mailing Address - Fax:502-489-5751
Practice Address - Street 1:279 KINGS DAUGHTERS DR STE 204
Practice Address - Street 2:FRANKFORT
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-6562
Practice Address - Country:US
Practice Address - Phone:502-875-9885
Practice Address - Fax:502-875-9882
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY27319207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64922230Medicaid
KY0720901Medicare ID - Type Unspecified
KYE84916Medicare UPIN