Derr, John W
Derr, John W is an individual health care provider with primary practice located at 4001 Kresge Way Suite 320, Louisville KY 40207-4640. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Derr, John W can be contacted via phone (502) 895-5850.Contact Information
Primary practice address
4001 Kresge Way Suite 320
Louisville KY 40207-4640
Phone: (502) 895-5850
Fax: (502) 895-1210
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | 25991 | Kentucky |
Profile Details
NPI number | 1801883988 |
---|---|
LBN Legal business name | Derr, John W |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 4th, 2005 |
Last updated | Oct 21st, 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 | 1801883988 | NPPES |
Indiana | MEDICAID | 100345240B | |
Indiana | MEDICAID | 64259914 |
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