Derksen, Jon Eric

Derksen, Jon Eric is an individual health care provider with primary practice located at 1644 Medical Center Pt Ste 200 , Colorado Springs CO 80907-5765. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Derksen, Jon Eric can be contacted via phone (719) 634-1994.

Contact Information

Primary practice address
1644 Medical Center Pt Ste 200 Colorado Springs CO 80907-5765
Phone: (719) 634-1994
Fax: (719) 634-2906
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 43884 Colorado

Profile Details

NPI number 1649254905
LBN Legal business name Derksen, Jon Eric
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated May 29th, 2018 - about 6 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 1649254905 NPPES
Colorado MEDICAID 48473081

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