MEDICARE: JOHN C. DERICKSON OD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	OPC3107	FL

General Provider Information

NPI Number	:	1356686976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN C. DERICKSON OD, PA

Provider Business Mailing Address
First Line	:	8771 PERIMETER PARK CT
Second Line	:	SUITE 101
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6396
Country	:	US
Telephone Number	:	904-997-8585
Fax Number	:

Provider Business Practice Location Address
First Line	:	8771 PERIMETER PARK CT
Second Line	:	SUITE 101
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-6396
Country	:	US
Telephone Number	:	904-997-8585
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOHN CHRISTIAN DERICKSON
Credential	:	O.D.
Telephone Number	:	904-997-8585

Provider Enumeration Date	:	12/07/2012
Last Update Date	:	12/07/2012

Similar Medicare Providers

1245616317 — MATTHEW SUTTON
Practice Location Address:

8771 PERIMETER PARK CT , SUITE 101
JACKSONVILLE, FL
32216-6396

Practice Phone: 904-997-8585
Practice Fax:

1023433984 — PHYSICIANS FOR QUALITY HEALTHCARE, INC.
Practice Location Address:

6444 BEACH BLVD STE 200
JACKSONVILLE, FL
32216-2891

Practice Phone: 239-768-6396
Practice Fax: 239-204-3000

1063120053 — MRS. SOJHAM ANDREINA RAY CRUZ RBT
Practice Location Address:

5600 SPRING PARK RD STE 200
JACKSONVILLE, FL
32216-5989

Practice Phone: 786-525-3114
Practice Fax: 855-226-6396

1023452265 — YAISY COSTALES SADE MS, BCBA
Practice Location Address:

2730 CLYDO RD STE 4
JACKSONVILLE, FL
32207-7964

Practice Phone: 904-666-5147
Practice Fax: 855-226-6396

1033110374 — DR. DENA S MERRIMAN DPM
Practice Location Address:

2846 PARNHAM DR
MEDINA, OH
44256-4700

Practice Phone: 440-570-6396
Practice Fax: 330-334-1535

1568454056 — CAROLINA ORTHOPAEDIC AND NEUROSURGICAL ASSOCIATES
Practice Location Address:

1330 BOILING SPRINGS RD , STE 1600
SPARTANBURG, SC
29303-2244

Practice Phone: 864-582-6396
Practice Fax: 864-582-1608

Directions to “JOHN C. DERICKSON OD, PA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.