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Individual

DERRICK ALAN HENRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 FAIR PARK BLVD, LITTLE ROCK, AR 72204-1720
(501) 404-8007
(501) 904-3620
Mailing address
800 FAIR PARK BLVD, LITTLE ROCK, AR 72204-1720
(501) 404-8007
(501) 904-3620

Taxonomy

Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
31406
MS
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
67994
TN
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
E-16463
AR

Other

Enumeration date
04/02/2018
Last updated
07/02/2024
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