Individual
DR. DEBORAH F HAMMOND-WICKFALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
315 BOULEVARD NE, SUITE 520, ATLANTA, GA 30312-1200
(404) 265-6322
(404) 265-6321
Mailing address
PO BOX 54454, ATLANTA, GA 30308-0454
(404) 265-6322
(404) 265-6321
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21991
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
832158
BCBS PROVIDER I.D. #
GA
01
—
DC3236
RR MEDICARE GROUP I.D. #
GA
01
—
P00161487
RR MEDICARE PIN
GA
Enumeration date
01/24/2007
Last updated
07/09/2007
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