Individual
STACY HAMMOND STORY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 BLACKBURN DR, MARTINEZ, GA 30907-8201
(706) 854-8340
(706) 854-8388
Mailing address
2231 CUMMING RD, AUGUSTA, GA 30904-4335
(706) 829-3516
(706) 733-8044
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
017559
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
017559
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000151159C
—
GA
01
—
050045947
RAILROAD MEDICARE
GA
05
—
907941
—
SC
Enumeration date
07/11/2006
Last updated
03/12/2020
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