DR. DERRICK HASLEM (NPI# 1730389701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730389701 |
| Entity Type | Individual |
| Full Name | DR. DERRICK HASLEM |
| Credential | MD |
| Practice Address |
544 S 400 E St George UT 84770-3705 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 4356884900 |
| Mailing Telephone | 4356884900 |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2011-11-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 6020533-1205 | UT | Allopathic & Osteopathic Physicians |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
6020533-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
544 S 400 E |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84770-3705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205813474 | Rusty A Moore | Physical Medicine & Rehabilitation | 544 S 400 E, 5th Floor, St George, UT 84770-3705 | 2005-12-28 |
| 1265069066 | Ihc Health Services Inc | Internal Medicine | 544 S 400 E, St George, UT 84770-3705 | 2020-03-24 |
| 1477005783 | Nicole Cummins | Nurse Practitioner | 544 S 400 E, St George, UT 84770-3705 | 2016-11-03 |
| 1831558204 | Elisa Edwards | General Acute Care Hospital | 544 S 400 E, St George, UT 84770-3705 | 2016-02-15 |
| 1588057152 | Lisa Certonio | Nurse Practitioner | 544 S 400 E, St George, UT 84770-3705 | 2015-03-06 |
| 1073924312 | Nathaniel William Seck | Psychiatry & Neurology | 544 S 400 E, St George, UT 84770-3705 | 2014-05-08 |
| 1235481375 | Min Li | Nurse Practitioner | 544 S 400 E, St George, UT 84770-3705 | 2012-10-14 |
| 1215291992 | Matt Trane Webb | Nurse Practitioner | 544 S 400 E, St George, UT 84770-3705 | 2012-06-27 |
| 1053677245 | Richard C Tebbs II | Physician Assistant | 544 S 400 E, St George, UT 84770-3705 | 2012-04-02 |
| 1528339769 | Ihc Health Services Inc | Family Medicine | 544 S 400 E, St George, UT 84770-3705 | 2012-01-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740808500 | Redstone Reference Laboratories Inc | Clinical Medical Laboratory | 556 N Dixie Drive, Suite 2, St George, UT 84770 | 2020-07-08 |
| 1033776315 | Ecko Ashmore | Marriage & Family Therapist | 1173 S. 250 W. Bld 1 Ste 208, St. George, UT 84770 | 2019-05-22 |
| 1740844679 | Amy Darragh | Behavior Technician | 249 E Tabernacle St, Ste 100, St George, UT 84770 | 2019-04-25 |
| 1124598198 | Loren Kyle Gulbranson | Internal Medicine | Dixie Regional Medical Center, 515 South, 300 East, Saint George, UT 84770 | 2018-12-03 |
| 1487150728 | Sound Sleep Medical LLC | Durable Medical Equipment & Medical Supplies | 640 East 700 South Building 2, St. George, UT 84770 | 2018-04-04 |
| 1588162911 | Desert Edge Medical | Family Medicine | 1664 S Dixie Dr Ste D201, St George, UT 84770 | 2018-01-31 |
| 1568981314 | Jeffrey Joseph Peterson | Behavior Technician | 162 N 400 E Ste A-105, St. George, UT 84770 | 2017-09-13 |
| 1992242549 | Zachary Carey | Specialist/Technologist | 1115 W Diamond Valley Dr, Saint George, UT 84770 | 2017-01-20 |
| 1669920427 | Charles Taylor Church | Technician, Other | 474 West 200 East, St. George, UT 84770 | 2016-09-21 |
| 1952755480 | Hollystic Hideaway | Voluntary or Charitable | 1418 W Sunset Blvd. # 2, Saint George, UT 84770 | 2016-04-21 |
| Find all providers in zip 84770 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851631139 | Central Utah Clinic, P.C. | Internal Medicine | 2019 E Riverside Dr, Suite A200, St George, UT 84790-8134 | 2013-02-22 |
| 1871735340 | Zachary Lawrence Reese | Internal Medicine | 544 S 400 E, St George, UT 84770-3705 | 2009-03-30 |
| 1447420401 | Ihc Health Services Inc | Internal Medicine | 544 S 400 E, St George, UT 84770-3705 | 2008-03-06 |
| 1437361185 | Karen Lin | Internal Medicine | 544 S 400 E, St George, UT 84770-3705 | 2007-05-04 |
| 1700946423 | Joseph Derit Te | Internal Medicine | 2019 E Riverside Dr Ste A200, St George, UT 84790-8693 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881123172 | Scott Marriner Browning | Internal Medicine | 2318 E Field Rose Dr, Salt Lake City, UT 84121-1500 | 2017-06-08 |
| 1356745137 | University of Utah Adult Services | Internal Medicine | 1950 E Circle of Hope Drive, Salt Lake City, UT 84112 | 2014-10-22 |
| 1982049227 | Bryan D Huber | Internal Medicine | 8th Avenue & C Street E8, Salt Lake City, UT 84143-3403 | 2013-04-30 |
| 1285929430 | Brandt L Esplin | Internal Medicine | 1055 N 500 W Ste 202, Bldg C, Provo, UT 84604-8460 | 2011-06-16 |
| 1457664005 | Sabarinath Venniyil Radhakrishna | Internal Medicine | 2000 Circle of Hope, Suite 2100, Huntsman Cancer Institute, Salt Lake City, UT 84112 | 2010-07-23 |
| 1427273705 | Utah Hematology Oncology PC | Internal Medicine | 4403 Harrison Blvd Ste 1685, Ogden, UT 84403-3274 | 2007-04-13 |
| 1225164114 | Finn Bo Petersen | Internal Medicine | E8 Lds Hospital, 8th Avenue and C Street, Salt Lake City, UT 84143-0001 | 2007-02-26 |
| 1124172697 | Justin A Call | Internal Medicine | 3592 W 9000 S, Ste 200, West Jordan, UT 84088-8812 | 2007-01-22 |
| 1164524864 | Jay C Bott | Internal Medicine | 177 S 240 W, Orem, UT 84058-3052 | 2006-09-02 |
| 1417995911 | Wendy A Breyer | Internal Medicine | 5171 S Cottonwood St Ste 610, Murray, UT 84107-5704 | 2006-06-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.