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
| License | State | Type | Specialty |
|---|---|---|---|
| OS008868L | PA | MD | Ophthalmology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001705510 | Medicaid | PA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dderck7287@direct.geisinger.edu | Direct |
Other providers in Sunbury, PA
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- Juan F. Delgado
- Shawn Dephillips
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- Digital Hearing Aid Sytems, Inc
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All providers in Sunbury, PA · Ophthalmology Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.