Provider Demographics
NPI:1740645605
Name:DRUMMOND, JARED MARTIN (AUD)
Entity type:Individual
Prefix:DR
First Name:JARED
Middle Name:MARTIN
Last Name:DRUMMOND
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 STATE ROAD 44 STE D
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-6438
Mailing Address - Country:US
Mailing Address - Phone:920-232-4752
Mailing Address - Fax:920-385-4979
Practice Address - Street 1:2390 STATE ROAD 44 STE D
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-6438
Practice Address - Country:US
Practice Address - Phone:920-232-4752
Practice Address - Fax:920-385-4979
Is Sole Proprietor?:No
Enumeration Date:2015-12-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI614-156231H00000X
FLAY1977231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist