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General NPI Number Information
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NPI Number | 1962533083
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Entity Type | Individual
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Provider Name | MICHELLE LEIGH MYERS D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 01/02/2015
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Provider Practice Location Address
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Address Line | 746 N COLLEGE RD SUITE D
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City | TWIN FALLS
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State | ID
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Zip | 83301-3486
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Country | US
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Telephone | 208-814-7230
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Fax | 208-734-1178
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Provider Business Mailing Address
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Address Line | PO BOX 587
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City | TWIN FALLS
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State | ID
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Zip | 83303-0587
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Country | US
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Telephone | 208-814-7400
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Fax | 208-814-7491
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | O-0524
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License Number State | ID
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