Provider Demographics
NPI:1831164011
Name:HAMMONDS, WILLIAM DARRELL (MD, MPH)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DARRELL
Last Name:HAMMONDS
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80883
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30608-0883
Mailing Address - Country:US
Mailing Address - Phone:706-549-8114
Mailing Address - Fax:
Practice Address - Street 1:748 OLD NORCROSS ROAD
Practice Address - Street 2:SUITE 150
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3395
Practice Address - Country:US
Practice Address - Phone:770-771-5445
Practice Address - Fax:770-771-5440
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA33745207LP2900X
GA014053207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA23442OtherWELLMARK BCBS
IAI0275Medicare ID - Type Unspecified
D29671Medicare UPIN
IA0218503Medicaid