Individual provider · Type 1 NPI

Randall Frederick Dierking Jr., IDC

Independent Duty Corpsman · Groton, CT

NPI number 1790752111 Active

Practice location

1 Wahoo Ave, Undersea Medicine
Groton, CT 06340-2324

Call (860) 449-4247 Map

Mailing address

7 Hart St
Groton, CT 06340-3321

Specialties and licenses

TaxonomyCodeLicense
Independent Duty Corpsman Primary 1710I1002XNone listed

Independent Duty Corpsman: A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and othe…

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About NPI 1790752111

Randall Frederick Dierking Jr., IDC's National Provider Identifier is 1790752111, issued on Mar 3, 2006. The primary taxonomy on file is Independent Duty Corpsman (1710I1002X), and the practice location is in Groton, CT. The record was last updated on May 3, 2010.