Van Derwood, John Gayle
Van Derwood, John Gayle is an individual health care provider with primary practice located at 7101 Us Highway 90 Suite 202, Daphne AL 36526-9512. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Van Derwood, John Gayle can be contacted via phone (251) 625-8211.Contact Information
Primary practice address
7101 Us Highway 90 Suite 202
Daphne AL 36526-9512
Phone: (251) 625-8211
Fax: (251) 625-8219
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 14230 | Mississippi |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 11539 | Alabama |
Profile Details
NPI number | 1205949013 |
---|---|
LBN Legal business name | Van Derwood, John Gayle |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 16th, 2006 |
Last updated | Dec 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1205949013 | NPPES |
Alabama | Other | 510-04616 | BLUE CROSS OF AL |
Alabama | MEDICAID | 051558401 | BLUE CROSS OF AL |
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