Individual
ERICK CHARLES DEROCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
411 N RANDALL AVE, ELK CITY, OK 73644-4127
(580) 243-2273
(580) 243-2832
Mailing address
411 N RANDALL AVE, ELK CITY, OK 73644-4127
(580) 243-2273
(580) 243-2832
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OK2573
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000300B
—
OK
Enumeration date
08/13/2006
Last updated
12/08/2014
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