Provider Demographics
NPI:1346070695
Name:GARFIELD, DEREK SR (CHA I)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:
Last Name:GARFIELD
Suffix:SR
Gender:M
Credentials:CHA I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:KOTZEBUE
Mailing Address - State:AK
Mailing Address - Zip Code:99752-0043
Mailing Address - Country:US
Mailing Address - Phone:907-948-2218
Mailing Address - Fax:
Practice Address - Street 1:P.O. BOX 3
Practice Address - Street 2:
Practice Address - City:KOBUK
Practice Address - State:AK
Practice Address - Zip Code:99751-0003
Practice Address - Country:US
Practice Address - Phone:907-948-6250
Practice Address - Fax:907-948-6269
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK7179151172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty