Provider Demographics
NPI:1700924404
Name:TOTTY, DEREK CRAIG (DC)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:CRAIG
Last Name:TOTTY
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 1:205 SONDRA CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3857
Mailing Address - Country:US
Mailing Address - Phone:615-758-7101
Mailing Address - Fax:615-758-7102
Practice Address - Street 1:541 N MOUNT JULIET RD
Practice Address - Street 2:SUITE 2101
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3873
Practice Address - Country:US
Practice Address - Phone:615-758-7101
Practice Address - Fax:615-758-7102
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor