Derrico, Anthony Christopher

Derrico, Anthony Christopher is an individual health care provider with primary practice located at 2003 Kootenai Health Way , Coeur D Alene ID 83814-6051. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Derrico, Anthony Christopher can be contacted via phone (208) 625-5700.

Contact Information

Primary practice address
2003 Kootenai Health Way Coeur D Alene ID 83814-6051
Phone: (208) 625-5700
Fax: (208) 625-5708
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X TL-4136 Idaho
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X O-1453 Idaho
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 81336-021 Wisconsin

Profile Details

NPI number 1538516471
LBN Legal business name Derrico, Anthony Christopher
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2016
Last updated Apr 24th, 2024 - about 8 months 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 1538516471 NPPES
Wisconsin MEDICAID 100254122

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