Whiteside, Derric A.
Whiteside, Derric A. is an sole proprietor health care provider with primary practice located at 4700 Las Vegas Blvd N , Nellis Afb NV 89191-6600. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Whiteside, Derric A. can be contacted via phone (702) 653-3128.Contact Information
Primary practice address
4700 Las Vegas Blvd N
Nellis Afb NV 89191-6600
Phone: (702) 653-3128
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 02003810A | Indiana |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 0102203353 | Virginia |
Profile Details
| NPI number | 1083877518 |
|---|---|
| LBN Legal business name | Whiteside, Derric A. |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 3rd, 2008 |
| Last updated | Aug 7th, 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.
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