Individual
DR. DAVID RONALD DERR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
807 STEELS POINTE, MADISON, MS 39110
(601) 331-5934
(601) 815-1854
Mailing address
601 DODDS AVE, CHATTANOOGA, TN 37404-3911
(423) 826-8220
(423) 698-3622
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
18738
MS
2085R0202X
Diagnostic Radiology Physician
Primary
44204
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01536317
—
MS
01
—
512G700003
MS MEDCIARE - GROUP
MS
01
—
P00261751
RAILROAD MEDICARE
MS
Enumeration date
06/30/2006
Last updated
07/21/2022
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