Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LUCAS R DERTING, PA-C
DeactivatedLUCAS R DERTING, PA-C is a Physician Assistant healthcare provider located in PUEBLO, Colorado. NPI 1306846381 is deactivated in the NPPES registry. Verify at CMS.
Physician Assistant · PUEBLO, CO
This NPI has been deactivated.
The record was deactivated on March 22, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1306846381
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 29, 2005 (0.64657534246575 yrs)
- Last Updated
- Nov 3, 2016
- Deactivated
- Mar 22, 2006
- Licenses
-
1080 (CO)1080 (CO)
Practice Information
- Address
-
1600 NORTH GRAND AVENUESUITE 500PUEBLO, CO, 810032757Browse CO providers · Browse ZIP 81003
- Phone
- 7195450663
- Fax
- 7195957903
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Surgical Physician Assistant
Other Physician Assistant Providers in PUEBLO, CO
| Name | Credential | NPI |
|---|---|---|
| STEPHEN D BAST | PA-C | 1922001700 |
| TERRY LEE SCHWARTZ | PA-C | 1255370318 |
| BECKY L KUETER | PA | 1780629394 |
| WENDY A BULOW | PA | 1376579540 |
| CHAD R HESS | PA | 1972531713 |
| JOSEPH A BULOW | PA | 1669402202 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.