National Provider Identifier

Derrick Michael Thornton, DO

Derrick Michael Thornton, DO is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Buffalo, NY and a listed phone number of (716) 645-9700.

NPI 1447054168Buffalo, NYStudent in an Organized Health Care Education/Training Program

Profile Overview

NPI
1447054168
Provider Type
Individual
Primary Specialty
Student in an Organized Health Care Education/Training Program
Enumeration Date
April 02, 2025
Last Updated
April 02, 2025

Practice Location

  • 77 Goodell St Ste 304
  • Buffalo, NY 14203-1243

Phone: (716) 645-9700

Mailing Address

  • 16309 E Brewster RD Apt A304
  • Covington, LA 70433-7320

Specialties

  • Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
NPI
1447054168
Entity Type
Individual
Last Name
Thornton
First Name
Derrick
Middle Name
Michael
Credential
DO
Mailing Street Address
16309 E Brewster RD Apt A304
Mailing City
Covington
Mailing State
LA
Mailing ZIP Code
70433-7320
Mailing Country
US
Practice Street Address
77 Goodell St Ste 304
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14203-1243
Practice Country
US
Practice Phone
(716) 645-9700
Enumeration Date
April 02, 2025
Last Updated
April 02, 2025
Sex
Male
Sole Proprietor
No
Certification Date
April 02, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Student in an Organized Health Care Education/Training Program (390200000X)