# DEREK J ORTON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1790742724
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 49025 | WI | Yes |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | 49025 | WI | — |

## Other

- **Enumeration date:** 04/26/2006
- **Last updated:** 04/01/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 34841100 | — | WI |
| 01 | — | P01114676 | RR MEDICARE | WI |