Individual
DR. DEREK JAMES DETEMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1741 E MORTEN AVE STE C1, PHOENIX, AZ 85020-4645
(602) 870-0194
Mailing address
1741 E MORTEN AVE STE C1, PHOENIX, AZ 85020-4645
(602) 870-0194
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
3763
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3981220
EVERCARE - GROUP #
AZ
05
—
695942
—
AZ
01
—
AW1436
HEALTHNET - GROUP #
AZ
01
—
AZ0728670
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
11/22/2005
Last updated
07/16/2007
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