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Contact Information

FRED J DERY JR, MD
2301 STEINDLER WAY STE B
NORTH LIBERTY, IA52317-7907
 Phone: 319-338-3606
 Fax: 319-338-0522
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Pain Medicine

208VP0000X 72 Physician/Pain Management
Indicates primary specialty

NPI Profile & details for FRED J DERY JR · (Male)

NPI # 1457569188
Status Active
Credentials MD
Entity Individual
Enumeration date 05/18/2007
Last updated 03/28/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IA License # 38968
  • IA Medicaid 1457569188
  • IA Other I75560005 MEDICARE PTAN
Hospital affiliation(s)
  • GREAT RIVER MEDICAL CENTER - (Acute Care)
    1221 SOUTH GEAR AVENUE
    WEST BURLINGTON, IA 52655
  • JEFFERSON COUNTY HEALTH CENTER - (Critical Access)
    2000 S MAIN
    FAIRFIELD, IA 52556
  • WASHINGTON COUNTY HOSPITAL - (Critical Access)
    400 EAST POLK STREET
    WASHINGTON, IA 52353
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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