Provider Demographics
NPI:1588278618
Name:HAMMONS, JOSHUA COLE
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:COLE
Last Name:HAMMONS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2134 WEEPING WILLOW CIR
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-6096
Mailing Address - Country:US
Mailing Address - Phone:601-520-4441
Mailing Address - Fax:
Practice Address - Street 1:139 FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1303
Practice Address - Country:US
Practice Address - Phone:601-450-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-05
Last Update Date:2021-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904329363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily