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Keith J. Derickson, MD
Family Medicine Physician in Fort Wayne, Indiana
NPI 1538480439

Keith J. Derickson is a Family Medicine Physician based in Fort Wayne, IN. Keith J. Derickson practices in Fort Wayne, IN and has the professional credentials of MD. The NPI Number for Keith J. Derickson is 1538480439 and holds a License No. 01070470A (Indiana).

The current practice location address for Keith J. Derickson is 6404 Rothman Rd, Fort Wayne, IN and can be reached out via phone at 260-486-6197 and via fax at 260-486-9862.

Location: 6404 Rothman Rd, Fort Wayne, IN, 46804-7934
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538480439
Provider Name
Keith J. Derickson
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
6404 Rothman Rd, Fort Wayne, IN, 46804-7934
Phone Number
260-486-6197
Fax Number
260-486-9862
Provider Enumeration Date
06/15/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
201047100 05 IN
institution
Provider Business Practice Location Address Details
Address
6404 Rothman Rd
City
Fort Wayne
State
Indiana
Zip
46835-1366
Phone Number
260-486-6197
Fax Number
260-486-9862
person
Provider Business Mailing Address Details
Address
6404 Rothman Rd
City
Fort Wayne
State
Indiana
Zip
46835-1366
Phone Number
260-486-6197
Fax Number
260-486-9862
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
01070470A (Indiana)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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