Provider Demographics
NPI:1780765719
Name:MATHESON, DEREK M (DO)
Entity type:Individual
Prefix:DR
First Name:DEREK
Middle Name:M
Last Name:MATHESON
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:226 SE DEBELL
Mailing Address - Street 2:BLDG A
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006
Mailing Address - Country:US
Mailing Address - Phone:918-331-1089
Mailing Address - Fax:918-331-1823
Practice Address - Street 1:3500 FRANK PHILLIPS
Practice Address - Street 2:HOSPITALIST
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006
Practice Address - Country:US
Practice Address - Phone:918-331-1089
Practice Address - Fax:918-331-1823
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2013-10-23
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Provider Licenses
StateLicense IDTaxonomies
OK4359207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine