Dennis D. Derck, D.O.

Individual provider Active NPI Ophthalmology Physician · Sunbury, PA

NPI 1831165992 · NPPES record last updated Aug 19, 2020

Key facts

NPI
1831165992
Entity type
Individual (NPI type 1)
Primary specialty
Ophthalmology Physician 207W00000X
License
OS008868L (PA)
Practice address
385 State St
Sunbury, PA 17801-2531
Phone
(570) 286-6773
Fax
(570) 286-7967
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS008868LPAMDOphthalmology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X OS008868L PA Yes

Addresses

Primary practice location

385 State St
Sunbury, PA 17801-2531

Mailing address

100 N Academy Ave
Danville, PA 17822-3034
Phone (570) 271-6144

Other identifiers

IdentifierTypeStateIssuer
001705510MedicaidPA

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address dderck7287@direct.geisinger.edu Direct

Other providers in Sunbury, PA

All providers in Sunbury, PA · Ophthalmology Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.