Jerold A. Derkaz, Md Pa
LBN: Jerold A. Derkaz, Md Pa
Jerold A. Derkaz, Md Pa is an health care organization with primary practice located at 1290 Circle Dr , Defuniak Springs FL 32435-2505. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty.
Jerold A. Derkaz, Md Pa can be contacted via phone (850) 892-6600, or through Arcabascio, Amanda via phone (850) 892-6600.
Contact Information
Primary practice address
1290 Circle Dr
Defuniak Springs FL 32435-2505
Phone: (850) 892-6600
Fax: (850) 520-4660
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME0046412 | Florida |
Profile Details
| NPI number | 1477736106 |
|---|---|
| LBN Legal business name | Jerold A. Derkaz, Md Pa |
| DBA Doing business as | |
| Authorized official | Arcabascio, Amanda |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 17th, 2007 |
| Last updated | May 19th, 2011 - about 15 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477736106 | NPPES |
| Florida | Other | 76015 | BCBS |
| Florida | Other | K3534 | BCBS |
| Florida | MEDICAID | 262982800 | BCBS |
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