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Contact Information

DEREK DERKACS, PA-C
100 E. IDAHO ST
BOISE, ID83712
 Phone: 208-381-2733
 Fax: 208-381-2482
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for DEREK DERKACS · (Male)

NPI # 1720157720
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 11/06/2006
Last updated 04/10/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • ID License # PA-740
Hospital affiliation(s)
  • GRANDE RONDE HOSPITAL - (Critical Access)
    900 SUNSET DRIVE
    LA GRANDE, OR 97850
  • ST LUKE'S ELMORE MEDICAL CENTER - (Critical Access)
    895 NORTH 6TH EAST
    MOUNTAIN HOME, ID 83647
  • ST LUKES MAGIC VALLEY RMC - (Acute Care)
    801 POLE LINE ROAD WEST
    TWIN FALLS, ID 83301
  • ST LUKES REGIONAL MEDICAL CENTER - (Acute Care)
    190 EAST BANNOCK STREET
    BOISE, ID 83712
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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