James L Derickson (NPI# 1023035524, PAC ID# 9234191404) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1023035524 |
| PAC ID by PECOS | 9234191404 |
| Professional Enrollment ID | I20071102000205 |
| Full Name | James L Derickson |
| Organization Legal Name | MARIPOSA COMMUNITY HEALTH CENTER |
| Address |
1103 Circulo Mercado Suite E Rio Rico AZ 85648-6249 |
| Phone Number | 52028115501307 |
| Gender | M |
| Credential | MD |
| Medical School | OHIO STATE UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 1970 |
| Primary Specialty | FAMILY PRACTICE |
| Group Practice PAC ID | 8123926326 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1852 N Mastick Way, Nogales, AZ 85621-1063 | 52028115501307 | MARIPOSA COMMUNITY HEALTH CENTER |
| 1103 Circulo Mercado, Suite E, Rio Rico, AZ 85648-6249 | 52028115501307 | MARIPOSA COMMUNITY HEALTH CENTER |
| Organization Legal Name | MARIPOSA COMMUNITY HEALTH CENTER |
| Physicians | 15 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Emily T Roth | Nurse Practitioner | Mariposa Community Health Center | 1852 N Mastick Way, Nogales, AZ 85621-1063 |
| Valerie A Wohl | Family Medicine | Mariposa Community Health Center | 1852 N Mastick Way, Nogales, AZ 85621-1063 |
| Steven J Dudick | Obstetrics/gynecology | Mariposa Community Health Center | 1852 N Mastick Way, Nogales, AZ 85621-1063 |
| Rosa Isela Machado | Family Medicine | Mariposa Community Health Center | 1852 N Mastick Way, Nogales, AZ 85621-1063 |
| Eladio Pereira | Internal Medicine | Mariposa Community Health Center | 1852 N Mastick Way, Nogales, AZ 85621-1063 |
| Jorge Omar Flores Lopez | Internal Medicine | Mariposa Community Health Center | 1852 N Mastick Way, Nogales, AZ 85621-1063 |
| Mary Garcia-kumirov | Family Medicine | Mariposa Community Health Center | 1852 N Mastick Way, Nogales, AZ 85621-1063 |
| Molly Anderson | Family Medicine | Mariposa Community Health Center | 1852 N Mastick Way, Nogales, AZ 85621-1063 |
| Carmelo Echeverria | Family Medicine | Mariposa Community Health Center | 1852 N Mastick Way, Nogales, AZ 85621-1063 |
| Michael Md Hinkson | Internal Medicine | Mariposa Community Health Center | 1852 N Mastick Way, Nogales, AZ 85621-1063 |
| Street Address |
1103 CIRCULO MERCADO SUITE E |
| City | RIO RICO |
| State | AZ |
| Zip | 85648-6249 |
| City | RIO RICO |
| Zip Code | 85648 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | RIO RICO + FAMILY PRACTICE |
Please comment or provide details below to improve the information on James L Derickson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.