Individual
DR. JOHNNY BRUCE HAMMONS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 TRILLIUM WAY, SUITE 306, CORBIN, KY 40701-8490
(606) 526-4070
(606) 526-4072
Mailing address
PO BOX 1325, CORBIN, KY 40702-1325
(606) 526-8131
(606) 528-8661
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
46997
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100316770
—
KY
01
—
P01384617
RR MEDICARE
KY
Enumeration date
05/11/2011
Last updated
12/04/2020
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