Individual
DR. DEREK WAYNE ASHBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
326 DOZIER AVE, CANON CITY, CO 81212-2706
(719) 276-0344
(719) 269-7446
Mailing address
326 DOZIER AVE, CANON CITY, CO 81212-2706
(719) 276-0344
(719) 269-7446
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT-2652
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376983924
GROUP NPI
—
01
—
1679525208
OFFICE GROUP NPI
—
05
—
87751747
—
CO
01
—
P00827172
RAILROAD MEDICARE
—
Enumeration date
06/25/2008
Last updated
06/28/2013
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