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NPI Code Detail

MEDICARE: DR. JAMES FREDERIC DRUCKENBROD M.D.

MEDICARE: DR. JAMES FREDERIC DRUCKENBROD M.D.
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
1103T00000XPsychologistMD035059LPA

General Provider Information

NPI Number : 1619974011
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES FREDERIC DRUCKENBROD M.D.
Provider Business Mailing Address
First Line : 820 5TH AVE
Second Line :
City : CHAMBERSBURG
State : PA
Zip : 17201-4219
Country : US
Telephone Number : 717-263-0384
Fax Number : 717-263-6753
Provider Business Practice Location Address
First Line : 820 5TH AVE
Second Line :
City : CHAMBERSBURG
State : PA
Zip : 17201-4219
Country : US
Telephone Number : 717-263-0384
Fax Number : 717-263-6753
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 07/08/2007

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