Creighton, Derrick Daniel
Creighton, Derrick Daniel is an individual health care provider with primary practice located at 2432 Eagleridge Dr , Henderson NV 89074-6295. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Creighton, Derrick Daniel can be contacted via phone (573) 576-2701.Contact Information
Primary practice address
2432 Eagleridge Dr
Henderson NV 89074-6295
Phone: (573) 576-2701
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | PENDING | Texas |
Profile Details
| NPI number | 1134254824 |
|---|---|
| LBN Legal business name | Creighton, Derrick Daniel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2007 |
| Last updated | Apr 22nd, 2012 - about 13 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 | 1134254824 | NPPES |
| Missouri | Other | 46165 | GHP |
| Missouri | MEDICAID | 01060802 | GHP |
| Missouri | MEDICAID | 237246265001 | GHP |
| Missouri | Other | 153 | GHP |
| Missouri | MEDICAID | 186416701 | GHP |
| Missouri | Other | 110375 | GHP |
| Missouri | Other | 8X9731 | GHP |
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