Individual
DR. DEREK M FEUQUAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 214-2920
(928) 214-2925
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
41740
AZ
208M00000X
Hospitalist Physician
Primary
41740
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41740
ARIZONA LICENSE
AZ
05
—
466692
—
AZ
Enumeration date
06/13/2007
Last updated
09/02/2022
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