Provider Demographics
NPI:1376646851
Name:DRUMMOND, MICHAEL FREEMAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FREEMAN
Last Name:DRUMMOND
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 HWY 78 EAST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501
Mailing Address - Country:US
Mailing Address - Phone:205-221-3880
Mailing Address - Fax:205-221-3629
Practice Address - Street 1:1206 HWY 78 EAST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501
Practice Address - Country:US
Practice Address - Phone:205-221-3880
Practice Address - Fax:205-221-3629
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL30961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice