Healthcare Provider Details
I. General information
NPI: 1346557238
Provider Name (Legal Business Name): LEIF E. MEYERS, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/13/2010
Last Update Date: 09/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1460 G ST
SPRINGFIELD OR
97477-4112
US
IV. Provider business mailing address
PO BOX 11840
WESTMINSTER CA
92685-1840
US
V. Phone/Fax
- Phone: 541-726-4400
- Fax:
- Phone: 562-468-0227
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LEIF
E
MEYERS
Title or Position: MD
Credential: MD
Phone: 541-726-4400