Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. DEREK PORT, ATC
Active Sole ProprietorMR. DEREK PORT, ATC is a Athletic Trainer healthcare provider located in CAMPBELLSVILLE, Kentucky. NPI 1487004636 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · CAMPBELLSVILLE, KY
Registration Details
- NPI Number
- 1487004636
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 20, 2016 (10.110490889343 yrs)
- Last Updated
- Jun 20, 2016
- License
-
AT512 (KY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1 UNIVERSITY DRUPO #823CAMPBELLSVILLE, KY, 427182190Browse KY providers · Browse ZIP 42718
- Phone
- 2707895544
- Fax
- 2707895199
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in CAMPBELLSVILLE, KY
| Name | Credential | NPI |
|---|---|---|
| TRACY LEE LOTT | MS, ATC | 1205068335 |
| JEANETTA FORD | MS, LAT, ATC | 1649543240 |
| ELLY WRIGHT | MAT, LAT, ATC | 1528580446 |
| JUSTIN MICHAEL RAMOS | MS, LAT, ATC | 1356837470 |
| KAITLYN SANFILIPPO | MA, ATC, LAT | 1336703495 |
| MR. RYAN DAVID LEE | LAT, ATC | 1093369852 |
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.