Provider Demographics
NPI:1548292824
Name:HAMMONDS, BRUCE L (OD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:L
Last Name:HAMMONDS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2281 HOG MOUNTAIN RD
Mailing Address - Street 2:STE C
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-4846
Mailing Address - Country:US
Mailing Address - Phone:706-769-4404
Mailing Address - Fax:706-769-0687
Practice Address - Street 1:2281 HOG MOUNTAIN RD
Practice Address - Street 2:STE C
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-4846
Practice Address - Country:US
Practice Address - Phone:706-769-4404
Practice Address - Fax:706-769-0687
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA000905152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAT97626Medicare UPIN