# DEREK J CRIPPS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Derek J Cripps MD LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659524981
- **Authorized official:** DR. DEREK JAMES CRIPPS M.D. (EMERITUS PROFESSOR OF MEDICINE)
- **Authorized official phone:** (608) 244-1712

## Contact information

- **Practice address:** 2817 NEW PINERY RD, PORTAGE, WI 53901-9257
- **Practice address phone:** (608) 745-5093
- **Mailing address:** 727 WILDER DR, MADISON, WI 53704-6011
- **Mailing address phone:** (608) 244-1712
- **Mailing address fax:** (608) 244-4338

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 15388 | WI | Yes |

## Other

- **Enumeration date:** 10/30/2008
- **Last updated:** 10/30/2008