Individual
DR. RICHARD DERBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
670 PIERCE BLVD, O FALLON, IL 62269-2579
(618) 206-2094
Mailing address
670 PIERCE BLVD, O FALLON, IL 62269-2579
(618) 206-2094
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036126121
IL
Other
Enumeration date
09/20/2005
Last updated
12/29/2021
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