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Individual

DERRICK ROTH FANSLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2222 N NEVADA AVE, SUITE 4007, COLORADO SPRINGS, CO 80907
(719) 776-8500
(719) 634-1448
Mailing address
2222 N NEVADA AVE, SUITE 4007, COLORADO SPRINGS, CO 80907-6819
(719) 776-8500
(719) 634-1448

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
53906
CO
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
DR.0053906
CO

Other

Enumeration date
04/23/2009
Last updated
09/07/2018
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