MEDICARE: DERRICK WITMER D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4035	TN

General Provider Information

NPI Number	:	1013866219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DERRICK WITMER D.C.

Provider Business Mailing Address
First Line	:	354 OLD GALLATIN RD
Second Line	:
City	:	SCOTTSVILLE
State	:	KY
Zip	:	42164-8666
Country	:	US
Telephone Number	:	636-208-8163
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 HIGHWAY 52 BYP W
Second Line	:
City	:	LAFAYETTE
State	:	TN
Zip	:	37083-2636
Country	:	US
Telephone Number	:	615-622-7942
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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Directions to “ DERRICK WITMER D.C.” Practice Location

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