Provider Demographics
NPI:1538357363
Name:JERRY W. DRUMMOND, M.D., A.P.M.C.
Entity type:Organization
Organization Name:JERRY W. DRUMMOND, M.D., A.P.M.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:DRUMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-688-5710
Mailing Address - Street 1:2514 BERT KOUNS INDUSTRIAL LOOP
Mailing Address - Street 2:PHYSICIANS PLAZA #9
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-3146
Mailing Address - Country:US
Mailing Address - Phone:318-688-5710
Mailing Address - Fax:
Practice Address - Street 1:2514 BERT KOUNS INDUSTRIAL LOOP
Practice Address - Street 2:PHYSICIANS PLAZA #9
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-3146
Practice Address - Country:US
Practice Address - Phone:318-688-5710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty