Individual
DR. DEREK J SPETEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PHARM D
Contact information
Practice address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-7345
(618) 256-7121
Mailing address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-6500
(618) 256-7121
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
2005004197
MO
183500000X
Pharmacist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005004197
PHARMACY LICENSE
MO
Enumeration date
11/18/2005
Last updated
07/08/2007
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