Provider Demographics
NPI:1083965941
Name:DEMPSEY, DERRICK ALFRED (DC)
Entity Type:Individual
Prefix:DR
First Name:DERRICK
Middle Name:ALFRED
Last Name:DEMPSEY
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 1:1074 SILVER GULL DR
Mailing Address - Street 2:
Mailing Address - City:TEGA CAY
Mailing Address - State:SC
Mailing Address - Zip Code:29708-8232
Mailing Address - Country:US
Mailing Address - Phone:803-741-4481
Mailing Address - Fax:
Practice Address - Street 1:1074 SILVER GULL DR
Practice Address - Street 2:
Practice Address - City:TEGA CAY
Practice Address - State:SC
Practice Address - Zip Code:29708-8232
Practice Address - Country:US
Practice Address - Phone:803-741-4481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3690111N00000X
NC4221111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor