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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 14 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.

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Identifiers

StateTypeNumberIssuer
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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