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General NPI Number Information
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NPI Number | 1407276835
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Entity Type | Individual
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Provider Name | AUSTIN CLIFF MYERS MD, MBA
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Gender | Male
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 07/30/2018
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Provider Practice Location Address
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Address Line | 777 HOSPITAL WAY
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City | POCATELLO
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State | ID
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Zip | 83201
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Country | US
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Telephone | 208-239-2722
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Fax | 208-239-3759
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Provider Business Mailing Address
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Address Line | 777 HOSPITAL WAY
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City | POCATELLO
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State | ID
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Zip | 83201-5175
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Country | US
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Telephone | 208-239-2722
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Fax | 208-239-3758
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | M-14099
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License Number State | ID
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