Provider Demographics
NPI:1245661487
Name:HAMMOND, CLAIRE (PA)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:MARIE
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:46 LOUIS PRIMA DR
Mailing Address - Street 2:STE A
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-5903
Mailing Address - Country:US
Mailing Address - Phone:985-892-7070
Mailing Address - Fax:985-892-7017
Practice Address - Street 1:9300 MANSFIELD RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-3155
Practice Address - Country:US
Practice Address - Phone:318-629-3763
Practice Address - Fax:318-629-3767
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200680363A00000X
TXPA08661363AM0700X
LAPA.200680363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant