Basic Information
| Provider Information | |||||||||
| NPI: | 1366449209 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMMETT | ||||||||
| FirstName: | ALBERT | ||||||||
| MiddleName: | CLAY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 122152 | ||||||||
| Address2: | DEPT 2152 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753122152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3374942919 | ||||||||
| FaxNumber: | 3374943069 | ||||||||
| Practice Location | |||||||||
| Address1: | 1717 OAK PARK BLVD | ||||||||
| Address2: | 2ND FL | ||||||||
| City: | LAKE CHARLES | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706018991 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3374943278 | ||||||||
| FaxNumber: | 3374946969 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2005 | ||||||||
| LastUpdateDate: | 01/26/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 019890 | LA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | 019890 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 1910856 | 05 | LA | MEDICAID | 110224634 | 01 | LA | RR MEDICARE | OTHER |