Individual
ROBERT J DERICK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
855 W MARKET ST, STE A, LIMA, OH 45805
(419) 228-7432
(419) 228-5628
Mailing address
855 W MARKET ST, STE A, LIMA, OH 45805
(419) 228-7432
(419) 228-5628
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
55895
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L0837689
—
OH
Enumeration date
03/14/2006
Last updated
07/08/2007
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