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General NPI Number Information
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NPI Number | 1194507574
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Entity Type | Organization
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Legal Business Name | MYERS ORTHOPAEDICS LLC
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 15190 COMMUNITY RD STE 120
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City | GULFPORT
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State | MS
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Zip | 39503-3484
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Country | US
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Telephone | 228-575-7287
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Fax | 228-831-8782
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Provider Business Mailing Address
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Address Line | 15190 COMMUNITY RD STE 120
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City | GULFPORT
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State | MS
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Zip | 39503-3484
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Country | US
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Telephone | 228-575-7287
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Fax | 228-831-8782
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Authorized Official
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Title or Position | OWNER
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Name | PHILIP MYERS
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Credential | DO
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Telephone | 228-575-7287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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