Provider Demographics
NPI:1326238718
Name:DAVIDSON, DEREK C (DO, MSPT)
Entity type:Individual
Prefix:DR
First Name:DEREK
Middle Name:C
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:DO, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:271 PARK ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3311
Mailing Address - Country:US
Mailing Address - Phone:413-785-1153
Mailing Address - Fax:413-781-4951
Practice Address - Street 1:766 N KING ST STE 2
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-1143
Practice Address - Country:US
Practice Address - Phone:413-860-2305
Practice Address - Fax:413-586-1068
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA272213208100000X
TXBP10050540208100000X
MA17700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist