Provider Demographics
NPI:1134414709
Name:BITNER, DEREK P (MD)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:P
Last Name:BITNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:309 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-2946
Mailing Address - Country:US
Mailing Address - Phone:641-754-6200
Mailing Address - Fax:641-754-6245
Practice Address - Street 1:6200 WESTOWN PKWY
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-7705
Practice Address - Country:US
Practice Address - Phone:515-223-8685
Practice Address - Fax:515-223-5468
Is Sole Proprietor?:No
Enumeration Date:2011-06-12
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAMD-43354207W00000X, 207WX0110X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1134414709OtherWELLMARK
IA1134414709Medicaid
IA1134414709Medicaid