Provider Demographics
NPI:1427028778
Name:DERRICK & HARRISON PC
Entity Type:Organization
Organization Name:DERRICK & HARRISON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-348-7195
Mailing Address - Street 1:599 W STATE ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2567
Mailing Address - Country:US
Mailing Address - Phone:215-348-7195
Mailing Address - Fax:215-348-8633
Practice Address - Street 1:599 W STATE ST
Practice Address - Street 2:SUITE 301
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2567
Practice Address - Country:US
Practice Address - Phone:215-348-7195
Practice Address - Fax:215-348-8633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACG6738OtherTRAVELERS MEDICARE
334124OtherHIGHMARK BS
334124OtherHIGHMARK BS