Individual
DR. DERRICK HASLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
544 S 400 E, ST GEORGE, UT 84770-3705
(435) 688-4900
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(435) 688-4900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
6020533-1205
UT
207RH0003X
Hematology & Oncology Physician
Primary
6020533-1205
UT
Other
Enumeration date
07/19/2007
Last updated
09/08/2021
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