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
Fax: (502) 895-1210
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801883988 NPPES
Indiana MEDICAID 100345240B
Indiana MEDICAID 64259914

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