Individual
MR. DERRICK K SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
859 WINTER ST, LUCEDALE, MS 39452-6603
(601) 947-3161
(601) 947-9948
Mailing address
859 WINTER ST, LUCEDALE, MS 39452-6603
(601) 947-3161
(601) 947-9948
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R597066
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110750
—
MS
Enumeration date
08/03/2006
Last updated
11/09/2010
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