Organization
DERKASH PROFESSIONAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT S DERKASH M.D. (MEMBER/MANAGER)
(970) 945-9702
Entity
Organization
Contact information
Practice address
1906 BLAKE AVE, GLENWOOD SPRINGS, CO 81601-4298
(970) 945-8683
Mailing address
10918 COUNTY ROAD 245, NEW CASTLE, CO 81647-9410
(970) 984-0615
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22420
CO
Other
Enumeration date
08/11/2006
Last updated
03/31/2008
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