Provider Demographics
NPI:1477082915
Name:ALGER, DERRICK THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:DERRICK
Middle Name:THOMAS
Last Name:ALGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 3RD AVE SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-4009
Mailing Address - Country:US
Mailing Address - Phone:319-730-7300
Mailing Address - Fax:319-730-7368
Practice Address - Street 1:1201 3RD AVE SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-4009
Practice Address - Country:US
Practice Address - Phone:319-730-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-10894207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine