Individual
DEREK BOYD SOUTHWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 W VOTAW ST, PORTLAND, IN 47371-1322
(765) 741-1515
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01098270A
IN
Other
Enumeration date
04/01/2024
Last updated
03/30/2026
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