Healthcare Provider Details

I. General information

NPI: 1033426895
Provider Name (Legal Business Name): GARVEY LEE MEYERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 E BROADWAY
COLUMBIA MO
65201-8018
US

IV. Provider business mailing address

8604 N KIMMY CT
COLUMBIA MO
65202-8452
US

V. Phone/Fax

Practice location:
  • Phone: 573-875-2505
  • Fax:
Mailing address:
  • Phone: 573-808-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR8860
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: