Sanderson, Derrick J

Sanderson, Derrick J is an individual health care provider with primary practice located at 4199 Gateway Blvd Ste 3500 , Newburgh IN 47630-7909. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is his primary health care specialty. Sanderson, Derrick J can be contacted via phone (812) 858-5950.

Contact Information

Primary practice address
4199 Gateway Blvd Ste 3500 Newburgh IN 47630-7909
Phone: (812) 858-5950
Fax: (812) 858-5955
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 283330 New York
Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery 207VF0040X 02005887A Indiana

Profile Details

NPI number 1043577448
LBN Legal business name Sanderson, Derrick J
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2012
Last updated Aug 27th, 2020 - 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 1043577448 NPPES
Indiana MEDICAID 300038901
Indiana MEDICAID 7100666260

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