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General NPI Number Information
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NPI Number | 1710053939
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Entity Type | Individual
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Provider Name | JOHN RUSSELL MEYERS MD
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Gender | Male
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 128 EAST AVE STE 1
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City | NORWALK
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State | CT
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Zip | 06851
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Country | US
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Telephone | 203-857-1866
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Fax | 203-857-1866
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Provider Business Mailing Address
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Address Line | 128 EAST AVE STE 1
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City | NORWALK
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State | CT
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Zip | 06851-5741
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Country | US
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Telephone | 203-857-1866
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Fax | 203-857-1865
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 41859
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License Number State | CT
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