Landis, Derek Todd

Landis, Derek Todd is an individual health care provider with primary practice located at 921 14Th Ave Nw , Ardmore OK 73401-1837. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Landis, Derek Todd can be contacted via phone (580) 223-5311.

Contact Information

Primary practice address
921 14Th Ave Nw Ardmore OK 73401-1837
Phone: (580) 223-5311
Fax: (580) 223-8227
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 25666 Oklahoma

Profile Details

NPI number 1487854642
LBN Legal business name Landis, Derek Todd
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2007
Last updated May 20th, 2014 - about 10 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1487854642 NPPES
Oklahoma Other 25666 OKLAHOMA MEDICAL LICENSE
Oklahoma Other 36032 OKLAHOMA MEDICAL LICENSE

Popular Providers