Provider Demographics
NPI:1336236090
Name:DRAUGHN, DAVID GARDNER (MD FACS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GARDNER
Last Name:DRAUGHN
Suffix:
Gender:M
Credentials:MD FACS
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Mailing Address - Street 1:860 SUMMIT CROSSING PLACE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054
Mailing Address - Country:US
Mailing Address - Phone:704-861-2072
Mailing Address - Fax:704-854-3996
Practice Address - Street 1:860 SUMMIT CROSSING PL
Practice Address - Street 2:SUITE 120
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2216
Practice Address - Country:US
Practice Address - Phone:704-861-2072
Practice Address - Fax:704-854-3996
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2023-10-25
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Provider Licenses
StateLicense IDTaxonomies
NC9300088208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6929158Medicaid
NC6929158Medicaid
F59090Medicare UPIN