Basic Information
Provider Information
NPI: 1932426590
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMMOND
FirstName: WILLIAM
MiddleName: ADAM
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 45278
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 322325278
CountryCode: US
TelephoneNumber: 9042022092
FaxNumber: 9043937603
Practice Location
Address1: 1301 PALM AVE
Address2:  
City: JACKSONVILLE
State: FL
PostalCode: 322078432
CountryCode: US
TelephoneNumber: 9042027300
FaxNumber: 9042027433
Other Information
ProviderEnumerationDate: 04/22/2010
LastUpdateDate: 04/02/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/02/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XME119235FLN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X16223NHN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RH0003XME119235FLY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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