JOHN BURTON DERRICK

VIDALIA, GA
NPI1932253606
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: GA  01655)
Enumeration Date2007-01-22
Last Update Date2023-03-07
Business Address
-- JOHN BURTON DERRICK
300 ARLINGTON DR
VIDALIA, GA 30474-0645
Phone number: 912-538-0830
Mailing Address
-- JOHN BURTON DERRICK
300 ARLINGTON DR PO BOX 645
VIDALIA, GA 30475
Phone number: 912-538-0830
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