Provider Demographics
NPI:1114449659
Name:HAMMOUDEH, RACHEL (OD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HAMMOUDEH
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 COMMERCE AVE BLDG 2200
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4980
Mailing Address - Country:US
Mailing Address - Phone:678-892-3778
Mailing Address - Fax:
Practice Address - Street 1:2435 COMMERCE AVE BLDG 2200
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4980
Practice Address - Country:US
Practice Address - Phone:678-892-3778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-15
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT030.0133938152W00000X
TX10144152W00000X
OH007211152W00000X
CO0003364152W00000X
AZ002250152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist