Individual
DR. DONALD JOSEPH DERIVAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 MERIDIAN ST N, STE 200, HUNTSVILLE, AL 35801-4720
(256) 705-3937
(256) 533-3213
Mailing address
1013 CORONADO AVE SE, HUNTSVILLE, AL 35802-2650
(256) 882-1083
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
00014911
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000008502
MEDICARE INDIVIDUAL PROV
—
05
—
000008502
—
AL
01
—
051008502
BLUE CROSS BLUE SHIELD
AL
01
—
1497765721
NPI GROUP
—
01
—
180037758
RAILROAD MEDICARE
AL
01
—
H664
MEDICARE GROUP PROVIDER
AL
Enumeration date
12/21/2005
Last updated
05/08/2015
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