Provider Demographics
NPI:1841401494
Name:HAMMONDS, CARA (MD)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:HAMMONDS
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 1:225 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-7914
Mailing Address - Country:US
Mailing Address - Phone:270-441-4890
Mailing Address - Fax:270-441-4132
Practice Address - Street 1:225 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 206
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7914
Practice Address - Country:US
Practice Address - Phone:270-441-4890
Practice Address - Fax:270-441-4132
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN635207RR0500X
KY46612207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100130940Medicaid
KY7100130940Medicaid