Provider Demographics
NPI:1649226408
Name:DRUMMOND, JOHN A (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:DRUMMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:35 COLLIER RD NW
Mailing Address - Street 2:SUITE 175
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1671
Mailing Address - Country:US
Mailing Address - Phone:404-446-0456
Mailing Address - Fax:404-355-7184
Practice Address - Street 1:35 COLLIER RD NW
Practice Address - Street 2:SUITE 175
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1671
Practice Address - Country:US
Practice Address - Phone:404-446-0456
Practice Address - Fax:404-355-7184
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA16333207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00194268AMedicaid
GA511I110727Medicare PIN
GA00194268AMedicaid
11BDWDXMedicare ID - Type Unspecified