Individual
MR. DEREK DERKACS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 E. IDAHO ST, BOISE, ID 83712
(208) 381-2733
(208) 381-2482
Mailing address
100 E. IDAHO ST, BOISE, ID 83712
(208) 381-2733
(208) 381-2482
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-740
ID
Other
Enumeration date
11/06/2006
Last updated
04/10/2019
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