Provider Demographics
NPI:1962715086
Name:DEAN, DEREK ALAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DEREK
Middle Name:ALAN
Last Name:DEAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2232 GALLATIN PIKE N
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2000
Mailing Address - Country:US
Mailing Address - Phone:615-859-6216
Mailing Address - Fax:615-859-0971
Practice Address - Street 1:2232 GALLATIN PIKE N
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2000
Practice Address - Country:US
Practice Address - Phone:615-859-6216
Practice Address - Fax:615-859-0971
Is Sole Proprietor?:No
Enumeration Date:2010-07-18
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1962715086OtherNPPES