Individual
GRANT HAROLD HAMMONS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1429 N 6TH ST, TERRE HAUTE, IN 47807-1037
(812) 232-0564
(812) 242-4518
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3115
(812) 235-9580
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01054051A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000191999
ANTHEM
—
01
—
160053259
RAILROAD MCARE PALAMETTO
—
05
—
200331350
—
IN
05
—
200331350A
—
IN
05
—
200331350X
—
IN
01
—
P00855807
RAILROAD MEDICARE
IN
Enumeration date
08/25/2006
Last updated
03/14/2013
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