JAMES LYLE DERICKSON MD
NPI 1023035524
Family Medicine in Nogales, AZ

Active since July 17, 2006
1852 N MASTICK WAY, NOGALES, AZ 85621(520) 281-1550(520) 281-4487 Get Directions Write a Review

NPPES record last updated: November 28, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 28, 2018, Mar 1, 2018, Jun 29, 2016 (3 updates tracked since 2016).

About James Lyle Derickson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAMES LYLE DERICKSON MD (NPI 1023035524) is an individual family medicine provider in Nogales, Arizona, licensed in Arizona (37067) and active in the NPI registry since July 2006. He maintains a secondary practice location in Green Valley.

NPPES Registry Identity

NPI1023035524
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJAMES LYLE DERICKSONCredential: MD
Location Address1852 N MASTICK WAYNogales, AZ 85621
Mailing Address825 N Grand Ave Ste 100Nogales, AZ 85621-1061 · (520) 761-2133 · Fax (520) 281-2335
Fax(520) 281-4487
Sole ProprietorNo
Enumeration DateJuly 17, 2006
Last NPPES UpdateNovember 28, 20183 updates tracked since enumeration
NPI 1023035524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in AZ · 37067
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1852 N MASTICK WAY, Nogales, AZ 85621

Secondary Practice Location 1

Location 11260 S Campbell Rd, Building 2Green Valley, AZ 85614-2666 · Phone (520) 407-5800 · Fax (520) 407-5990

Other Identifiers 1

Medicaid266946AZ

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pediatrics
1852 N MASTICK WAY
NOGALES, AZ 85621
Registered Nurse (Obstetric, High-Risk)
1852 N MASTICK WAY, MARIPOSA COMMUNITY HEALTH CENTER
NOGALES, AZ 85621
Pediatrics
1852 N MASTICK WAY
NOGALES, AZ 85621
Pediatrics
1852 N MASTICK WAY
NOGALES, AZ 85621
Dentist
1852 N MASTICK WAY
NOGALES, AZ 85621
Pediatrics
1852 N MASTICK WAY
NOGALES, AZ 85621
Nurse Practitioner
1852 N MASTICK WAY
NOGALES, AZ 85621
Dentist (General Practice)
1852 N MASTICK WAY
NOGALES, AZ 85621

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1023035524, enumerated as an "individual" on July 17, 2006.

The provider is located at 1852 N MASTICK WAY NOGALES, AZ 85621 and the phone number is (520) 281-1550.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.