Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 16843 | MS |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 2820-94 | MS |
N | 204E00000X | Oral & Maxillofacial Surgeon | 16843 | MS |
N | 204E00000X | Oral & Maxillofacial Surgeon | 2820-94 | MS |
NPI | 1134250855 |
---|---|
Provider Name | Dr. James Joel Drummond |
First Address | Meridian, MS 39301-3104 |
Second Address | Meridian, MS 39301-3104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 05/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00123549 | (05) | MS |
704900 | UNITED CONCORDIA (01) | MS |
H38190 | (02) | MS |
P00618912 | MEDICARE PTAN (01) | MS |