Individual
DEREK J ORTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9000 W SURA LN, GREENFIELD, WI 53228-3477
(262) 329-2225
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
49025
WI
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
49025
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34841100
—
WI
01
—
P01114676
RR MEDICARE
WI
Enumeration date
04/26/2006
Last updated
04/01/2024
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