| Hammoud Neurology Llc | |
|
975 Mezzanine Dr Ste C Lafayette IN 47905-8635 | |
| (765) 446-5220 | |
| (765) 446-5220 |
| Full Name | Hammoud Neurology Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 975 Mezzanine Dr Ste C, Lafayette, Indiana |
| Authorized Official Name and Position | Khaled Hammoud (OWNER/PHYSICIAN) |
| Authorized Official Contact | 7655887675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hammoud Neurology Llc 975 Mezzanine Dr Ste C Lafayette IN 47905-8635 Ph: (765) 446-5220 | Hammoud Neurology Llc 975 Mezzanine Dr Ste C Lafayette IN 47905-8635 Ph: (765) 446-5220 |
| NPI Number | 1730937384 |
|---|---|
| Provider Enumeration Date | 05/08/2024 |
| Last Update Date | 05/11/2024 |
| Certification Date | 05/11/2024 |
| Medicare PECOS PAC ID | 5395280655 |
|---|---|
| Medicare Enrollment ID | O20240710004116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730937384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | (* (Not Available)) | Primary |
| Provider Name | Khaled Hammoud |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982806402 PECOS PAC ID: 4486846268 Enrollment ID: I20101012000723 |
| Provider Name | Kristina L Renfrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346765617 PECOS PAC ID: 6406128602 Enrollment ID: I20170823001957 |
| Provider Name | Jessica Stombaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992473755 PECOS PAC ID: 6103207261 Enrollment ID: I20220720002239 |
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