Derek Jeremy John is a Clinical in Wausau, Wisconsin. Derek Jeremy John practices all healthcare services and medical treatments related to Clinical. The NPI Number for Derek Jeremy John is 1912926601. The last update date is 2007-07-08.
Derek Jeremy John's current location address is 631 Forest St, Wausau, Wisconsin. You can contact this provider via phone number 7158420944 and fax number 7158456477. The mailing address for Derek Jeremy John is 631 Forest St, Wausau, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Derek Jeremy John |
|---|---|
| Address | 631 Forest St, Wausau, Wisconsin |
| Phone Number | 7158420944 |
| Fax Number | 7158456477 |
| Sole Proprietor | N |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1912926601 |
|---|---|
| Provider Enumeration Date | 2006-07-19 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 631 Forest St |
|---|---|
| City | Wausau |
| State | Wisconsin (WI) |
| Post Code | 544035524 |
| Phone Number | 7158420944 |
| Fax Number | 7158456477 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 2306-057 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 87249 | WI | SECURITY HEALTH INSURANCE | |
| 332603 | MANAGED HEALTH NETWORK | ||
| 2187795 | CIGNA BEHAVIORAL HEALTH |
Post Comment/ Review Below
What is the Derek Jeremy John's unique identification number?
The Derek Jeremy John has been assigned the NPI (National Provider Identifier) Number 1912926601 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you kindly provide the complete physical address where Derek Jeremy John's facilities are geographically located?
The facilities of Derek Jeremy John are physically situated at the following location: 631 Forest St, Wausau, WI, 544035524.
What is the area of specialization for Derek Jeremy John, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Derek Jeremy John is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 103Tc0700X.
On what date was the 1912926601 assigned to Derek Jeremy John?
The Derek Jeremy John was issued its 1912926601 on 2006-07-19, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Derek Jeremy John last refreshed?
The information related to the Derek Jeremy John, including its address, specialty, and other relevant details, was last updated on 2007-07-08.