Derrisaw, James Alan

Derrisaw, James Alan is an individual health care provider with primary practice located at 1236 E Elizabeth St Suite 1, Fort Collins CO 80524-4000. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Derrisaw, James Alan can be contacted via phone (970) 224-2985.

Contact Information

Primary practice address
1236 E Elizabeth St Suite 1 Fort Collins CO 80524-4000
Phone: (970) 224-2985
Fax: (970) 472-9381
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 39525 Colorado
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 26018 Nebraska
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 6553A Wyoming
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X DR.0039525 Colorado

Profile Details

NPI number 1710975586
LBN Legal business name Derrisaw, James Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Jun 6th, 2013 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710975586 NPPES
Colorado MEDICAID 04051262
Colorado MEDICAID 119537900

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