Derrick, Dustin Clifton

Derrick, Dustin Clifton is an sole proprietor health care provider with primary practice located at 800 12Th Ave Ste 100 , Fort Worth TX 76104-2519. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Plastic Surgery. Allopathic & Osteopathic Physicians / Plastic Surgery is his primary health care specialty. Derrick, Dustin Clifton can be contacted via phone (817) 810-0770.

Contact Information

Primary practice address
800 12Th Ave Ste 100 Fort Worth TX 76104-2519
Phone: (817) 810-0770
Fax: (817) 820-0242
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X Q4085 Texas
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 57. 025880 Ohio
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X Q4085 Texas

Profile Details

NPI number 1295049070
LBN Legal business name Derrick, Dustin Clifton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 3rd, 2010
Last updated Oct 13th, 2021 - about 4 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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