Bergeson, Derek Scott
Bergeson, Derek Scott is an individual health care provider with primary practice located at 1055 N 500 W Attn Credentialing, Provo UT 84604-8460. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Bergeson, Derek Scott can be contacted via phone (801) 354-8225.Contact Information
Primary practice address
1055 N 500 W Attn Credentialing
Provo UT 84604-8460
Phone: (801) 354-8225
Fax: (801) 418-0941
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 45556 | Colorado |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 12767278-1205 | Utah |
Profile Details
| NPI number | 1164641387 |
|---|---|
| LBN Legal business name | Bergeson, Derek Scott |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 25th, 2007 |
| Last updated | Jun 30th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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