| Jerold A. Derkaz, Md Pa | |
|
1290 Circle Dr Defuniak Springs FL 32435-2505 | |
| (850) 892-6600 | |
| (850) 520-4660 |
| Full Name | Jerold A. Derkaz, Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1290 Circle Dr, Defuniak Springs, Florida |
| Authorized Official Name and Position | Amanda Arcabascio (RECEPTIONIST) |
| Authorized Official Contact | 8508926600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerold A. Derkaz, Md Pa 1290 Circle Dr Defuniak Springs FL 32435-2505 Ph: (850) 892-6600 | Jerold A. Derkaz, Md Pa 1290 Circle Dr Defuniak Springs FL 32435-2505 Ph: (850) 892-6600 |
| NPI Number | 1477736106 |
|---|---|
| Provider Enumeration Date | 12/17/2007 |
| Last Update Date | 05/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477736106 | NPI | - | NPPES |
| 76015 | Other | FL | BCBS |
| K3534 | Other | FL | MEDICARE ID |
| 262982800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME0046412 (Florida) | Primary |
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