Individual
DEREK GUY ZICKGRAF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3175 POCAHONTAS RD, BAKER CITY, OR 97814
(541) 523-4415
(541) 523-2399
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(541) 523-4415
(541) 523-2399
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO181773
OR
Other
Enumeration date
07/08/2010
Last updated
03/29/2017
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