DERRICK RAY HAVIN M.D. NPI 1467563304

Obstetrics & Gynecology in Spokane, WA

Individual Male Obstetrics & Gynecology PECOS Enrolled Accepts Medicare Years Experience 21

About DERRICK HAVIN

Derrick Havin is a provider established in Spokane, Washington and his medical specialization is obstetrics & gynecology with more than 21 years of experience. The NPI number of Derrick Havin is 1467563304 and was assigned on August 2006. The practitioner's primary taxonomy code is 207V00000X with license number MD0046334 (WA). The provider is registered as an individual and his NPI record was last updated 2 years ago. Derrick Havin is enrolled in PECOS and registered with Medicare accepting claims assignment.

NPI

1467563304

Provider Name DERRICK RAY HAVIN M.D.
Provider Location Address101 W 8TH AVE STE 1300 SPOKANE, WA 99204
Provider Mailing AddressPO BOX 421 LIBERTY LAKE, WA 99019
GenderMale
NPI Entity TypeIndividual
Medical School NameSAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year1999
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date08-31-2006
Last Update Date07-28-2017

Primary Taxonomy

Taxonomy Code207V00000X
ClassificationObstetrics & Gynecology
TypeAllopathic & Osteopathic Physicians
License No.MD0046334
License StateWA
Taxonomy DescriptionAn obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Business Address

DERRICK RAY HAVIN M.D.
101 W 8TH AVE STE 1300
SPOKANE, WA
ZIP 99204
Phone: (509) 474-7370
Fax: (509) 474-7372

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Mailing Address

DERRICK RAY HAVIN M.D.
PO BOX 421
LIBERTY LAKE, WA
ZIP 99019
Phone:

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
8457327MEDICAID (05)WA
1467563304MEDICARE PIN (08)WA
H51527MEDICARE UPIN (02)WA
1821100132MEDICARE PIN (08)WA
8862634MEDICARE PIN (08)WA

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.

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