Individual
DR. JERRY WELTON DRUMMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2514 BERT KOUNS IND LOOP, PHYSICIANS PLAZA #9, SHREVEPORT, LA 71118
(318) 688-5710
(318) 688-5766
Mailing address
2514 BERT KOUNS IND LOOP, PHYSICIANS PLAZA #9, SHREVEPORT, LA 71118
(318) 688-5710
(318) 688-5766
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
002586FELLOWAMACADEM
LA
207W00000X
Ophthalmology Physician
Primary
MD03856R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1176061
—
LA
Enumeration date
10/02/2006
Last updated
07/08/2007
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