Individual
BENJAMIN MATTHEW DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
121 N 20TH ST STE 6, OPELIKA, AL 36801-5454
(347) 493-3853
Mailing address
5001 HARDY ST, HATTIESBURG, MS 39402-1308
(160) 129-6396
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2304
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/23/2017
Last updated
09/20/2021
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