Healthcare Provider Details

I. General information

NPI: 1669458147
Provider Name (Legal Business Name): STEVEN R MYERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 12/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 N CIRCLE DR SUITE 100
COLORADO SPRINGS CO
80909-1182
US

IV. Provider business mailing address

3010 N CIRCLE DR SUITE 100
COLORADO SPRINGS CO
80909-1182
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-4740
  • Fax: 719-776-4750
Mailing address:
  • Phone: 719-776-4740
  • Fax: 719-776-4750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number29640
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: