Healthcare Provider Details

I. General information

NPI: 1689750168
Provider Name (Legal Business Name): JOEL S MEYERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 05/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 DRY CREEK DR
LONGMONT CO
80503-6505
US

IV. Provider business mailing address

1400 DRY CREEK DR
LONGMONT CO
80503-6499
US

V. Phone/Fax

Practice location:
  • Phone: 303-772-3300
  • Fax: 303-682-3380
Mailing address:
  • Phone: 303-772-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number32209
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number32209
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: