Individual
LUCAS BRYAN HAMMOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
1416 WINCHESTER ST, JACKSON, MS 39211-5638
(334) 441-5185
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
T-5126
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2023
Last updated
07/02/2023
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