Individual
JOHN W DERR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
4001 KRESGE WAY, SUITE 320, LOUISVILLE, KY 40207-4640
(502) 895-5850
(502) 895-1210
Mailing address
4001 KRESGE WAY, SUITE 320, LOUISVILLE, KY 40207-4640
(502) 895-5850
(502) 895-1210
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25991
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100345240B
—
IN
05
—
64259914
—
KY
Enumeration date
10/04/2005
Last updated
10/21/2014
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