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Contact Information

JAMES L DERICKSON, MD
1852 N MASTICK WAY
NOGALES, AZ85621
 Phone: 520-281-1550
 Fax: 520-281-4487
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for JAMES L DERICKSON · (Male)

NPI # 1023035524
Status Active
Credentials MD
Entity Individual
Enumeration date 07/17/2006
Last updated 11/28/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 37067
  • AZ Medicaid 266946
Hospital affiliation(s) Not Available
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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