NPI 1013902055

Dirk Jon Derksen, MD

Practitioner Family Medicine Physician Appleton, WI

Practice location

Address: 10 Wagon Wheel Dr, Appleton, WI 54913-9782
Phone: (920) 731-6374

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence AD6655394 (WI)

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Registry record

NPI: 1013902055
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Sep 2005
Record last updated: 17 Feb 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.