Provider Demographics
NPI:1700141033
Name:HAMMETT, MALCOLM REID (MD)
Entity type:Individual
Prefix:DR
First Name:MALCOLM
Middle Name:REID
Last Name:HAMMETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 GLENEAGLES DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-5757
Mailing Address - Country:US
Mailing Address - Phone:903-561-9609
Mailing Address - Fax:
Practice Address - Street 1:7001 GLENEAGLES DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-5757
Practice Address - Country:US
Practice Address - Phone:903-561-9609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC8296207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology