Provider Demographics
NPI:1477616142
Name:DRUMMOND, DONALD THORNTON (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:THORNTON
Last Name:DRUMMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 N CONGRESS AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3283
Mailing Address - Country:US
Mailing Address - Phone:561-844-2233
Mailing Address - Fax:561-840-9425
Practice Address - Street 1:2151 N CONGRESS AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3283
Practice Address - Country:US
Practice Address - Phone:561-844-2233
Practice Address - Fax:561-840-9425
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50557208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL501173OtherVACCINES FOR CHILDREN
FL001732700Medicaid
FLME50557OtherSTATE MEDICAL LICENSE
FLA16776Medicare UPIN