MEDICARE: DR. DANIEL L MYERS M.D.

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	208600000X	Surgery Physician	04-22246	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	102503	OTHER	KS	BCBS

General Provider Information

NPI Number	:	1184622599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL L MYERS M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 804
Second Line	:
City	:	IOLA
State	:	KS
Zip	:	66749-0804
Country	:	US
Telephone Number	:	620-228-8106
Fax Number	:	620-365-1233

Provider Business Practice Location Address
First Line	:	1408 EAST ST
Second Line	:
City	:	IOLA
State	:	KS
Zip	:	66749-4402
Country	:	US
Telephone Number	:	620-365-3115
Fax Number	:	620-365-1233

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

Provider Enumeration Date	:	07/09/2005
Last Update Date	:	08/03/2011

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