Provider Demographics
NPI:1578734364
Name:DAVID H. DRUCKER, M.D.
Entity Type:Organization
Organization Name:DAVID H. DRUCKER, M.D.
Other - Org Name:DAVID H. DRUCKER, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:DRUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-278-0880
Mailing Address - Street 1:1308 MEMORIAL DR STE 2
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-2577
Mailing Address - Country:US
Mailing Address - Phone:706-278-0880
Mailing Address - Fax:706-278-0859
Practice Address - Street 1:1308 MEMORIAL DR STE 2
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2577
Practice Address - Country:US
Practice Address - Phone:706-278-0880
Practice Address - Fax:706-278-0859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA19515207Q00000X
GA19515207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAB02937Medicare UPIN