Provider Demographics
NPI:1841282654
Name:HAMMOND-MOULTON, CATHY L (MD)
Entity type:Individual
Prefix:DR
First Name:CATHY
Middle Name:L
Last Name:HAMMOND-MOULTON
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 1:1210 BRIARVILLE RD BLDG E
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-5136
Mailing Address - Country:US
Mailing Address - Phone:615-860-8182
Mailing Address - Fax:615-860-8184
Practice Address - Street 1:1210 BRIARVILLE RD BLDG E
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5136
Practice Address - Country:US
Practice Address - Phone:615-860-8182
Practice Address - Fax:615-860-8184
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD37235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5151218OtherCIGNA
4088478OtherBCBS
4163547OtherBCBS
TN1376722546OtherNPI GROUP
1396030OtherAETNA
1841282654OtherNPI INDIVIDUAL
TN3892964OtherMEDICARE
TN3892964Medicaid
TN0102OtherAMERICHOICE
3892969Medicare PIN
1396030OtherAETNA
4088478OtherBCBS
5151218OtherCIGNA
3892967Medicare PIN
TN38929641Medicare PIN