Derrick, John Burton

Derrick, John Burton is an sole proprietor health care provider with primary practice located at 300 Arlington Dr , Vidalia GA 30474-0645. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Derrick, John Burton can be contacted via phone (912) 538-0830.

Contact Information

Primary practice address
300 Arlington Dr Vidalia GA 30474-0645
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 01655 Georgia

Profile Details

NPI number 1932253606
LBN Legal business name Derrick, John Burton
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 22nd, 2007
Last updated Mar 7th, 2023 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932253606 NPPES
Georgia Other 01655 LICENSE

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