Individual
DR. DEREK SOUTHWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
505 PARNASSUS AVE RM M779, UCSF DEPARTMENT OF NEUROSURGERY, SAN FRANCISCO, CA 94143
(415) 353-3904
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-5085
(208) 625-5731
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
M14301
ID
Other
Enumeration date
04/04/2011
Last updated
08/09/2018
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