Dr. Kevin Mathew Derickson
Primary Podiatric Medicine
2770 Capital Medical Blvd Ste 200 Ste 200
Tallahassee
, Florida 32308-8419
Dr. Kevin Mathew Derickson
Primary Podiatric Medicine
2770 Capital Medical Blvd Ste 200 Ste 200
Tallahassee
, Florida 32308-8419
(850) 219-2352
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About
Features
Specialties
- Primary Podiatric Medicine
Languages spoken
- English
Location
First Address
- Dr. Kevin Mathew Derickson
- 2770 Capital Medical Blvd Ste 200 Ste 200
- Tallahassee, FL
- Zip : 32308-8419
- Fax : (850) 219-2352
- Phone : (850) 878-8235
Second Address
- Dr. Kevin Mathew Derickson
- 2770 Capital Medical Blvd Ste 200 Ste 200
- Tallahassee, FL
- Zip : 32308-8419
- Fax : (850) 219-2352
- Phone : (850) 878-8235
Reviews
FAQs
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Is Dr. Kevin Mathew Derickson a sole practitioner?
Is Dr. Kevin Mathew Derickson accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213EP1101X | Primary Podiatric Medicine | PO2824 | FL |
National Provider Identifier
| NPI | 1396748497 |
|---|---|
| Provider Name | Dr. Kevin Mathew Derickson |
| First Address | Tallahassee, FL 32308-8419 |
| Second Address | Tallahassee, FL 32308-8419 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/05/2005 |
| Last Update Date | 20/08/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000901249C | (05) | GA |
| 340058100 | (05) | FL |
| 65635 | BCBS PROVIDER NUMBER (01) | FL |
| 99039 | GROUP BCBS ID (01) | FL |
| P00625824 | MEDICARE RAIL ROAD (01) | FL |
| U76655 | (02) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.