Provider Demographics
NPI:1023255387
Name:HAMMETT, LINDSEY R (PA-C)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:R
Last Name:HAMMETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 HARBERT DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45440-5117
Mailing Address - Country:US
Mailing Address - Phone:937-208-7575
Mailing Address - Fax:937-208-7590
Practice Address - Street 1:111 HARBERT DR
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45440-5117
Practice Address - Country:US
Practice Address - Phone:937-208-7575
Practice Address - Fax:937-208-7590
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.002806363AM0700X, 363A00000X
OH54.000538363AM0700X
OH55.000538363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH50.002806OtherSTATE LICENSE