Provider Demographics
NPI:1881442168
Name:PIERRON, DEREK M (OD)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:M
Last Name:PIERRON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:115 S TIPPECANOE DR
Mailing Address - Street 2:
Mailing Address - City:TIPP CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45371-1194
Mailing Address - Country:US
Mailing Address - Phone:937-667-1270
Mailing Address - Fax:937-667-7198
Practice Address - Street 1:115 S TIPPECANOE DR
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-1194
Practice Address - Country:US
Practice Address - Phone:937-667-1270
Practice Address - Fax:937-667-7198
Is Sole Proprietor?:No
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHOPT.007271152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist