Provider Demographics
NPI:1417909995
Name:DEBTER, AMY GAY (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:GAY
Last Name:DEBTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5407 HIXSON PIKE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4559
Mailing Address - Country:US
Mailing Address - Phone:423-710-1913
Mailing Address - Fax:423-710-1914
Practice Address - Street 1:5407 HIXSON PIKE
Practice Address - Street 2:SUITE 101
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4559
Practice Address - Country:US
Practice Address - Phone:423-710-1913
Practice Address - Fax:423-710-1914
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC 1735111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
103I700035OtherMEDICARE PTAN
TN4248692OtherBLUE CROSS BLUE SHIELD TN
TN745717OtherACN GROUP, INC. (OPTUMHEALTH)
TN0052280OtherCIGNA
103I700035OtherMEDICARE PTAN