MEDICARE: JEDIDIAH HAROLD MEYERS DO

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	207L00000X	Anesthesiology Physician	OP61228431	WA

General Provider Information

NPI Number	:	1245850593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEDIDIAH HAROLD MEYERS DO

Provider Business Mailing Address
First Line	:	MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVENUE
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98431-0001
Country	:	US
Telephone Number	:	253-968-1110
Fax Number	:	210-916-8712

Provider Business Practice Location Address
First Line	:	MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVENUE
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98431-0001
Country	:	US
Telephone Number	:	253-968-1110
Fax Number	:

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

Provider Enumeration Date	:	04/16/2020
Last Update Date	:	03/13/2026

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