Individual
DR. LEXI DERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
123 HOSPITAL DR, WATERTOWN, WI 53098-3331
(202) 618-2259
(920) 261-5343
Mailing address
123 HOSPITAL DR, WATERTOWN, WI 53098-3331
(217) 841-4810
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046.010474
IL
152W00000X
Optometrist
Primary
3659-35
WI
152W00000X
Optometrist
855TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046010474
—
IL
Enumeration date
07/06/2011
Last updated
08/25/2022
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