Dye, Derry Dean
Dye, Derry Dean is an individual health care provider with primary practice located at 225 Physicians Park Ste 400 , Poplar Bluff MO 63901-3923. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Dye, Derry Dean can be contacted via phone (573) 727-5500.Contact Information
Primary practice address
225 Physicians Park Ste 400
Poplar Bluff MO 63901-3923
Phone: (573) 727-5500
Fax: (573) 727-5599
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | R5G11 | Missouri |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | R5G11 | Missouri |
Profile Details
| NPI number | 1215949599 |
|---|---|
| LBN Legal business name | Dye, Derry Dean |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 13th, 2006 |
| Last updated | Feb 9th, 2023 - about last year |
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 | 1215949599 | NPPES |
| Missouri | MEDICAID | 202400024 |
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