MEDICARE: DR. MICHAEL FREEMAN DRUMMOND DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3096	AL

General Provider Information

NPI Number	:	1376646851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL FREEMAN DRUMMOND DMD

Provider Business Mailing Address
First Line	:	1206 HWY 78 EAST
Second Line	:
City	:	JASPER
State	:	AL
Zip	:	35501
Country	:	US
Telephone Number	:	205-221-3880
Fax Number	:	205-221-3629

Provider Business Practice Location Address
First Line	:	1206 HWY 78 EAST
Second Line	:
City	:	JASPER
State	:	AL
Zip	:	35501
Country	:	US
Telephone Number	:	205-221-3880
Fax Number	:	205-221-3629

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	07/08/2007

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