Kooker, Derrick D

Kooker, Derrick D is an individual health care provider with primary practice located at 2312 N Nevada Ave Ste 235 , Colorado Springs CO 80907-5312. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Kooker, Derrick D can be contacted via phone (719) 776-7600.

Contact Information

Primary practice address
2312 N Nevada Ave Ste 235 Colorado Springs CO 80907-5312
Phone: (719) 776-7600
Fax: (719) 473-3553
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA.0003166 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA961 Kentucky

Profile Details

NPI number 1851373526
LBN Legal business name Kooker, Derrick D
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Feb 9th, 2026 - about 8 months 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 1851373526 NPPES
Kentucky MEDICAID 7100001170
Kentucky Other P00604454

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