Hammond, Lara

Hammond, Lara is an individual health care provider with primary practice located at 305 W Jackson St Ste 303 , Carbondale IL 62901-1474. She recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as her primary health care specialty. Hammond, Lara can be contacted via phone (618) 351-9300.

Contact Information

Primary practice address
305 W Jackson St Ste 303 Carbondale IL 62901-1474
Phone: (618) 351-9300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 2016-02055 North Carolina
Allopathic & Osteopathic Physicians / Urology 208800000X 036-116220 Illinois

Profile Details

NPI number 1235167149
LBN Legal business name Hammond, Lara
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Mar 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235167149 NPPES
North Carolina Other NCU975A MEDICARE PTAN
North Carolina Other P00348700 MEDICARE PTAN
North Carolina MEDICAID 036116220 MEDICARE PTAN

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