MEDICARE: DR. JOEL R MEYER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	036084426	IL

General Provider Information

NPI Number	:	1083633424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL R MEYER MD

Provider Business Mailing Address
First Line	:	BANNER MD ANDERSON CANCER CENTER
Second Line	:	2940 E. BANNER GATEWAY DRIVE SUITE 350
City	:	GILBERT
State	:	AZ
Zip	:	85234
Country	:	US
Telephone Number	:	480-256-6444
Fax Number	:	480-256-3682

Provider Business Practice Location Address
First Line	:	BANNER MD ANDERSON CANCER CENTER
Second Line	:	2940 E. BANNER GATEWAY DRIVE SUITE 350
City	:	GILBERT
State	:	AZ
Zip	:	85234
Country	:	US
Telephone Number	:	480-256-6444
Fax Number	:	480-256-3682

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	10/01/2019

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