Derveloy, Robert Joseph

Derveloy, Robert Joseph is an individual health care provider with primary practice located at 830 S Gloster St Nmmc East Tower 4Th Floor, Tupelo MS 38801-4934. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Derveloy, Robert Joseph can be contacted via phone (662) 377-7170.

Contact Information

Primary practice address
830 S Gloster St Nmmc East Tower 4Th Floor Tupelo MS 38801-4934
Phone: (662) 377-7170
Fax: (662) 377-2423
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 12390 Mississippi

Profile Details

NPI number 1689674707
LBN Legal business name Derveloy, Robert Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Jul 8th, 2007 - about 18 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 1689674707 NPPES
Alabama Other 730-10331 BCBS
Alabama MEDICAID 00118384 BCBS

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