Hammond, Gaines Wardlaw

Hammond, Gaines Wardlaw is an individual health care provider with primary practice located at 320 Racetrack Rd Nw Ste 100C , Fort Walton Beach FL 32547-1796. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Hammond, Gaines Wardlaw can be contacted via phone (850) 863-0883.

Contact Information

Primary practice address
320 Racetrack Rd Nw Ste 100C Fort Walton Beach FL 32547-1796
Phone: (850) 863-0883
Fax: (850) 862-0188
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X P1320 Texas
Allopathic & Osteopathic Physicians / Urology 208800000X 9896 South Carolina
Allopathic & Osteopathic Physicians / Urology 208800000X ME130427 Florida

Profile Details

NPI number 1922168830
LBN Legal business name Hammond, Gaines Wardlaw
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2006
Last updated Jan 24th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922168830 NPPES
Florida MEDICAID 019470200
Florida MEDICAID 098968

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