Provider Demographics
NPI:1811947633
Name:MYERS, DEREK D (DC)
Entity type:Individual
Prefix:
First Name:DEREK
Middle Name:D
Last Name:MYERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3351 ASPEN GROVE DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2909
Mailing Address - Country:US
Mailing Address - Phone:615-472-1795
Mailing Address - Fax:615-472-1797
Practice Address - Street 1:3351 ASPEN GROVE DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2909
Practice Address - Country:US
Practice Address - Phone:615-472-1795
Practice Address - Fax:615-472-1797
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC1983111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNV03432Medicare UPIN