Individual
DEREK FLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2841 AVENUE G, WHITE CITY, OR 97503-3024
(309) 672-4977
Mailing address
2620 E BARNETT RD STE H, MEDFORD, OR 97504-8383
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO191255
OR
Other
Enumeration date
06/16/2016
Last updated
06/20/2019
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