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General NPI Number Information
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NPI Number | 1629156880
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Entity Type | Individual
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Provider Name | JEFFREY CHARLES MYERS PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 950 S. OCTORARA TRAIL
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City | PARKESBURG
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State | PA
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Zip | 19365-2100
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Country | US
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Telephone | 610-857-6639
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Fax | 610-857-6649
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Provider Business Mailing Address
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Address Line | 950 S. OCTORARA TRAIL
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City | PARKESBURG
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State | PA
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Zip | 19365-2100
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Country | US
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Telephone | 610-857-6639
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Fax | 610-857-6649
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA052044
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C5-0000480
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License Number State | DE
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