Individual
DR. DERECK A. PEERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
4546
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200124470A
—
OK
01
—
OK700279
INDIVIDUAL PTAN
OK
01
—
P00442554
RAILROAD MEDICARE
—
Enumeration date
04/03/2007
Last updated
07/23/2009
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