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Contact Information

TODD A DERKSEN, DPM
1301 E NORTHLAND AVE
STE B
APPLETON, WI54911
 Phone: 920-731-1999
 Fax: 920-731-3729
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for TODD A DERKSEN · (Male)

NPI Number 1053578682
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 05/21/2008
Last updated 08/19/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 953-25
  • WI Medicaid 43244900
Hospital affiliation(s)
  • APPLETON MED CTR - (Acute Care)
    1818 N MEADE ST
    APPLETON, WI 54911
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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