Provider Demographics
NPI:1104098862
Name:FORSTER, DEREK WALTER (MD)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:WALTER
Last Name:FORSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UK DIVISION OF INFECTIOUS DISEASES
Mailing Address - Street 2:740 S. LIMESTONE, K512 KY CLINIC
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0284
Mailing Address - Country:US
Mailing Address - Phone:859-323-8178
Mailing Address - Fax:859-323-8926
Practice Address - Street 1:3101 BEAUMONT CENTRE CIR STE 100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1959
Practice Address - Country:US
Practice Address - Phone:859-323-5544
Practice Address - Fax:859-257-9286
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45890207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease