Kenneth L Derrington, MD is a
Family Medicine physician based in Gravois Mills, Missouri. Kenneth L Derrington is licensed to practice in Missouri (license number R9A11) and his current practice location is 156 Missouri Blvd Ste B, Gravois Mills, Missouri. He can be reached at his office (for appointments etc.) via phone at
(573) 374-5263.
NPI number for Kenneth L Derrington is 1124023940 and his current mailing address is Po Box 1519, Laurie, Missouri. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1124023940.
Physician's Profile
| Full Name | Kenneth L Derrington |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 156 Missouri Blvd Ste B, Gravois Mills, Missouri |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1124023940
- Provider Enumeration Date: 06/17/2005
- Last Update Date: 03/19/2018
Medical Identifiers
Medical identifiers for Kenneth L Derrington such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124023940 | NPI | - | NPPES |
| 201366010 | Medicaid | MO | |
| R9A11 | Other | MO | MO LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | R9A11 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth L Derrington is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kenneth L Derrington, MD
Po Box 1519,
Laurie, MO 65038-1519
Ph: (573) 374-5800 | Kenneth L Derrington, MD
156 Missouri Blvd Ste B,
Gravois Mills, MO 65037-5394
Ph: (573) 374-5263 |
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