Provider Demographics
NPI:1588387591
Name:DRUMMOND, VERNON LEE JR
Entity type:Individual
Prefix:MR
First Name:VERNON
Middle Name:LEE
Last Name:DRUMMOND
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1318
Mailing Address - Street 2:600 SOUTH BOARDMAN
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87305-1318
Mailing Address - Country:US
Mailing Address - Phone:505-721-1000
Mailing Address - Fax:505-721-1099
Practice Address - Street 1:345 BASILLIO DRIVE
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301
Practice Address - Country:US
Practice Address - Phone:505-721-1800
Practice Address - Fax:505-721-1899
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM55435163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse