Liston, Derek Christopher
Liston, Derek Christopher is an individual health care provider with primary practice located at 401 East Vaughn Ave North Louisiana Medical Center, Ruston LA 71270. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Liston, Derek Christopher can be contacted via phone (318) 245-2456.Contact Information
Primary practice address
401 East Vaughn Ave North Louisiana Medical Center
Ruston LA 71270
Phone: (318) 245-2456
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 13553 | Hawaii |
Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MD44196 | Washington |
Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | MD202822 | Louisiana |
Profile Details
NPI number | 1083683957 |
---|---|
LBN Legal business name | Liston, Derek Christopher |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 14th, 2006 |
Last updated | May 4th, 2021 - about 3 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1083683957 | NPPES |
Louisiana | MEDICAID | 1882259 |
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