Healthcare Provider Details

I. General information

NPI: 1932026499
Provider Name (Legal Business Name): ROBERT WILLIAM MYERS PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4216 WASHINGTON RD STE 2
EVANS GA
30809-4717
US

IV. Provider business mailing address

1404 YELLOW TWIG LN
DYERSBURG TN
38024-2829
US

V. Phone/Fax

Practice location:
  • Phone: 706-814-5460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH12659
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: