Derickson, Theresa M
Derickson, Theresa M is an individual health care provider with primary practice located at 8040 Princeton-Glendale Rd. , West Chester OH 45069-0000. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Derickson, Theresa M can be contacted via phone (513) 872-2000.Contact Information
Primary practice address
8040 Princeton-Glendale Rd.
West Chester OH 45069-0000
Phone: (513) 872-2000
Fax: (513) 281-8842
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35088598 | Ohio |
Profile Details
| NPI number | 1639260169 |
|---|---|
| LBN Legal business name | Derickson, Theresa M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 28th, 2006 |
| Last updated | Oct 2nd, 2014 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639260169 | NPPES |
| Ohio | MEDICAID | 2704836 |
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