Provider Demographics
NPI:1598440562
Name:HAMMONS, LANE THOMAS (AUD)
Entity type:Individual
Prefix:DR
First Name:LANE
Middle Name:THOMAS
Last Name:HAMMONS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 WHITE PERCH RD
Mailing Address - Street 2:
Mailing Address - City:SIBLEY
Mailing Address - State:LA
Mailing Address - Zip Code:71073-2616
Mailing Address - Country:US
Mailing Address - Phone:318-525-2667
Mailing Address - Fax:
Practice Address - Street 1:5700 PHOENIX PL
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5782
Practice Address - Country:US
Practice Address - Phone:479-441-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9317231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist