Derby, Richard

Derby, Richard is an individual health care provider with primary practice located at 670 Pierce Blvd , O Fallon IL 62269-2579. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Derby, Richard can be contacted via phone (618) 206-2094.

Contact Information

Primary practice address
670 Pierce Blvd O Fallon IL 62269-2579
Phone: (618) 206-2094
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 036126121 Illinois

Profile Details

NPI number 1295720845
LBN Legal business name Derby, Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Dec 29th, 2021 - about 4 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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