MR. James Quincey Derrick, PA

NPI #1346471802 in Tierra Amarilla, New Mexico

Provider Information

NPI Number: 1346471802
Entity Type: Individual
Name: MR. James Quincey Derrick, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Jul 31, 2009
Last Updated: Aug 22, 2011

Practice Location

Address: CR 0324 HWY 84 N #14
City: Tierra Amarilla
State: New Mexico
ZIP Code: 87575
Phone: (575) 588-7252

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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