Organization
DEIBLER PSYCHIATRIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK S DEIBLER MD (MEDICAL DOCTOR)
(602) 791-1282
Entity
Organization
Contact information
Practice address
2120 W RESERVATION LOOP RD, CAMP VERDE, AZ 86322
(928) 567-5231
Mailing address
3132 W STEINBECK DR, ANTHEM, AZ 85086-1535
(602) 791-1282
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
32333
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32333
STATE LICENSE
AZ
05
—
967739
—
AZ
Enumeration date
08/07/2007
Last updated
11/05/2007
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