Individual
DERRICK DANIEL CREIGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2432 EAGLERIDGE DR, HENDERSON, NV 89074-6295
(573) 576-2701
Mailing address
2432 EAGLERIDGE DR, HENDERSON, NV 89074-6295
(573) 576-2701
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
PENDING
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01060802
—
MO
01
—
110375
HEALTHLINK
MO
01
—
153
ANTHEM BC/BS
MO
05
—
186416701
—
TX
05
—
237246265001
—
IL
01
—
46165
GHP
MO
01
—
8X9731
BCBS
TX
Enumeration date
02/22/2007
Last updated
04/22/2012
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