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:
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Health care specialties

SpecialtyCodeLicense #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 10 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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Identifiers

StateTypeNumberIssuer
All States NPI 1639260169 NPPES
Ohio MEDICAID 2704836

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