Provider Demographics
NPI:1245452671
Name:DOPPS, DERIN LEWIS (DC)
Entity type:Individual
Prefix:DR
First Name:DERIN
Middle Name:LEWIS
Last Name:DOPPS
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 1:5923 N EAST PARKVIEW ST
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67219-2320
Mailing Address - Country:US
Mailing Address - Phone:316-744-8228
Mailing Address - Fax:316-744-8448
Practice Address - Street 1:1615 E 61ST ST N
Practice Address - Street 2:SUITE 300
Practice Address - City:PARK CITY
Practice Address - State:KS
Practice Address - Zip Code:67219-1954
Practice Address - Country:US
Practice Address - Phone:316-744-8228
Practice Address - Fax:316-744-8448
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4946111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor