MEDICARE: JOHN PAUL DRUMMOND 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
1	207W00000X	Ophthalmology Physician	3675	LA

General Provider Information

NPI Number	:	1831192137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN PAUL DRUMMOND M.D.

Provider Business Mailing Address
First Line	:	471 ASHLEY RIDGE BLVD
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-7229
Country	:	US
Telephone Number	:	318-861-4009
Fax Number	:	318-861-4080

Provider Business Practice Location Address
First Line	:	471 ASHLEY RIDGE BLVD
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-7229
Country	:	US
Telephone Number	:	318-861-4009
Fax Number	:	318-861-4080

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	02/23/2009

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