Liston, Derek Christopher

Liston, Derek Christopher is an individual health care provider with primary practice located at 401 East Vaughn Ave North Louisiana Medical Center, Ruston LA 71270. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Liston, Derek Christopher can be contacted via phone (318) 245-2456.

Contact Information

Primary practice address
401 East Vaughn Ave North Louisiana Medical Center Ruston LA 71270
Phone: (318) 245-2456
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 13553 Hawaii
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD44196 Washington
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD202822 Louisiana

Profile Details

NPI number 1083683957
LBN Legal business name Liston, Derek Christopher
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated May 4th, 2021 - about 5 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 1083683957 NPPES
Louisiana MEDICAID 1882259

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