Provider Demographics
NPI:1003903378
Name:BESING, DEREK A (DPM)
Entity type:Individual
Prefix:DR
First Name:DEREK
Middle Name:A
Last Name:BESING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1160 E SAINT CLAIR ST
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-4853
Mailing Address - Country:US
Mailing Address - Phone:812-885-3325
Mailing Address - Fax:812-885-8499
Practice Address - Street 1:328 N 2ND ST STE 205
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1353
Practice Address - Country:US
Practice Address - Phone:812-882-3312
Practice Address - Fax:812-882-6181
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0700905213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL000000540311OtherANTHEM
IN000000540306OtherANTHEM
0936130001OtherDMERC ADMINISTRATOR
351576327OtherSAGAMONE
IN254060BOtherMEDICARE
480030220OtherMEDICARE RAILROAD
648091OtherHEALTHLINK
IN200281800Medicaid
IN200281800Medicaid
IN254060BOtherMEDICARE