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Contact Information

DEREK C LISTON, MD
401 EAST VAUGHN AVE
NORTH LOUISIANA MEDICAL CENTER
RUSTON, LA71270
 Phone: 318-245-2456
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for DEREK C LISTON · (Male)

NPI Number 1083683957
Status Active
Credentials MD
Entity Individual
Enumeration date 03/14/2006
Last updated 04/10/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • HI License # 13553
  • KS License # 04-46350
  • LA License # MD202822
  • WA License # MD44196
  • LA Medicaid 1882259
Hospital affiliation(s)
  • SAN LUIS VALLEY REGIONAL MEDICAL CENTER - (Acute Care)
    106 BLANCA AVE
    ALAMOSA, CO 81101
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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