person
John Burton Derrick
Medical Physician Assistant in Vidalia, Georgia
NPI 1932253606

John Burton Derrick is a Medical Physician Assistant based in Vidalia, GA and is specialized in Medical. John Burton Derrick practices in Vidalia, GA. The NPI Number for John Burton Derrick is 1932253606 and holds a License No. 01655 (Georgia).

The current practice location address for John Burton Derrick is 300 Arlington Dr, Vidalia, GA and can be reached out via phone at 912-538-0830.

Location: 300 Arlington Dr, Vidalia, GA, 30475
person
Provider Profile Details
NPI Number
1932253606
Provider Name
John Burton Derrick
Credential
Provider Entity Type
Individual
Gender
Male
Address
300 Arlington Dr, Vidalia, GA, 30475
Phone Number
912-538-0830
Fax Number
Provider Enumeration Date
01/22/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01655 01 GA LICENSE
institution
Provider Business Practice Location Address Details
Address
300 Arlington Dr
City
State
Zip
30474-0645
Phone Number
912-538-0830
Fax Number
person
Provider Business Mailing Address Details
Address
300 Arlington Dr
City
State
Zip
30474-0645
Phone Number
912-538-0830
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
01655 (Georgia)
Definition
Definition to come...
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