DERRICK S TOOTH


Address: 1053 Western Ave, Manchester, ME 04351-3403
Phone: 2076226319

DERRICK S TOOTH (NPI# 1639260847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1639260847
Entity Type Individual
Full Name DERRICK S TOOTH
Credential MD
Practice Address 1053 Western Ave
Manchester
ME 04351-3403
Mailing Address 9 Pleasant Street
Suite 2
Oakland
ME 04963
Practice Telephone 2076226319
Practice Fax Number 2076226654
Mailing Telephone 2074652700
Mailing Fax Number 2074652300
Enumeration Date 2006-09-27
Last Update Date 2012-12-05
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208800000X Urology 014663 ME Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
ME ANTHEM 030440 01
AETNA 1041053 01
ME 255890099 05

Office Location

Street Address 1053 WESTERN AVE
City MANCHESTER
State ME
Zip Code 04351-3403

Providers in the same location

NPI Name Taxonomy Address Enumeration
1013205558 Northern New England Diagnostics Clinical Medical Laboratory 1053 Western Ave, Manchester, ME 04351-3403 2011-07-19

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1497171318 Peter J Volk Family Medicine 23 Bowdoin Street, Manchester, ME 04351 2014-03-17
1740563428 Insight-premier Health LLC Clinic/Center 27 Bowdoin Street, Manchester, ME 04351 2011-09-20
1427353069 Robin Page Dufour Physical Therapist 6 Rockwood Dr, Suite 2, Manchester, ME 04351 2011-01-12
1174839708 Richard Ofoe Kavi Pharmacist 943 Western Ave, Manchester, ME 04351 2010-08-20
1700199031 Neil A Graves Pharmacist 943 Western Ave., Manchester, ME 04351 2010-07-15
1427212059 Dustin R Sulak Family Medicine 964 Western Ave., Manchester, ME 04351 2008-07-14
1437312295 Crossroads Counseling Center Pllc Social Worker 726 Western Ave., Manchester, ME 04351 2008-07-02
1548453616 Christopher Paul Beaudoin Social Worker 15 Range Way Suite 3, Manchester, ME 04351 2007-08-22
1275724288 Shawn Kenneth Hodgdon Social Worker 726 Western Avenue, Manchester, ME 04351 2007-08-05
1790900512 Scott A Hayward Social Worker 15 Range Way, Suite 3, Manchester, ME 04351 2007-04-16
Find all providers in zip 04351

Taxonomy Information

Taxonomy Code 208800000X
Grouping Allopathic & Osteopathic Physicians
Classification Urology

Taxonomy Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689842544 Sidney Robert Katz Urology 781 Smyth Rd, Va Medicalcenter, Manchester, NH 03104 2008-02-13
1396852786 Armando E Lopez Urology 718 Smyth Rd Fl 3, Manchester, NH 03104 2006-08-23
1588622757 Cyrus B Noble Urology 4 Elliot Way Ste 200, Manchester, NH 03103-3544 2006-05-03
1942276977 Arthur E. Lamontagne Jr. Urology 116 E Center St, Manchester, CT 06040-5215 2006-02-28
1922089903 Gary Douglas Corrie Urology 822 Mcarthur St, Manchester, TN 37355 2005-11-08
1003475914 Jason Akerman Urology 100 Hitchcock Way, Manchester, NH 03104-4125 2019-06-13
1578805164 John James Griffith Urology 360 Tolland Tpke, Manchester, CT 06042 2013-03-21
1699091546 Trisha Juliano Kammann Urology 4 Elliot Way, Suite 200, Manchester, NH 03103-3547 2010-04-18
1174705313 David Jeremy Rosenberg Urology 116 E Center St, Suite 19, Manchester, CT 06040-5215 2007-11-29
1043427438 Samuel T Snipes Urology 4 Elliot Way, Suite 200, Manchester, NH 03103-3547 2007-05-17
Find all providers in MANCHESTER

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City MANCHESTER
Zip Code 04351

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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