Individual
MR. DEREK PHILLIP JAMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMA
Contact information
Practice address
SR 264 MP 388, HOPI HEALTH CARE CENTER, POLACCA, AZ 86042-4000
(928) 737-6000
Mailing address
PO BOX 4000, POLACCA, AZ 86042-4000
(928) 737-6000
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
586073
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020529
—
AZ
Enumeration date
04/08/2010
Last updated
04/08/2010
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