DR. Jack Derby, OD

NPI #1841671948 in Marion, Indiana

Provider Information

NPI Number: 1841671948
Entity Type: Individual
Name: DR. Jack Derby, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Jun 15, 2015
Last Updated: Jun 15, 2015

Practice Location

Address: 506 S WASHINGTON ST
City: Marion
State: Indiana
ZIP Code: 46953-1961
Phone: (765) 662-6648

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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