Healthcare Provider Details

I. General information

NPI: 1043947724
Provider Name (Legal Business Name): JAMES DRUCKENMILLER HIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JIM DRUCKENMILLER

II. Dates (important events)

Enumeration Date: 08/03/2022
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 WINDSOR SQUARE DR
MATTHEWS NC
28105-4662
US

IV. Provider business mailing address

8516 SOUTHGATE COMMONS DR
CHARLOTTE NC
28277-2226
US

V. Phone/Fax

Practice location:
  • Phone: 704-845-8663
  • Fax:
Mailing address:
  • Phone: 901-301-3399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1678
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: