Healthcare Provider Details

I. General information

NPI: 1518598838
Provider Name (Legal Business Name): ANDREW MYLER PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2020
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6530 E 8TH AVE
ANCHORAGE AK
99504-1716
US

IV. Provider business mailing address

BLANCHFIELD ARMY COMMUNITY ARMY HOSPITAL 650 JOEL DR
FORT CAMPBELL KY
42223
US

V. Phone/Fax

Practice location:
  • Phone: 719-330-8728
  • Fax: 270-412-6802
Mailing address:
  • Phone: 270-956-0693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: