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Individual

DEREK JOHN DE VRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
842 E MAIN ST, MEDFORD, OR 97504-7134
(541) 773-9720
Mailing address
PO BOX 1705, MEDFORD, OR 97501-0132
(541) 773-7273
(541) 773-2027

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
56079-020
WI
207L00000X
Anesthesiology Physician
Primary
MD170937
OR

Other

Enumeration date
03/24/2010
Last updated
04/10/2015
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