Provider Demographics
NPI:1972645000
Name:HAMMOND, D. CORYDON (PHD)
Entity Type:Individual
Prefix:DR
First Name:D.
Middle Name:CORYDON
Last Name:HAMMOND
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY MEDICAL CENTER PMR
Mailing Address - Street 2:30 NO. 1900 EAST
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-2119
Mailing Address - Country:US
Mailing Address - Phone:801-581-5741
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY MEDICAL CENTER PMR
Practice Address - Street 2:30 NO. 1900 EAST
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-2119
Practice Address - Country:US
Practice Address - Phone:801-581-5741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT107195-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical