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NPI Code Detail

MEDICARE: DR. FREDERICK MYERS M.D.

MEDICARE: DR. FREDERICK 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
1208600000XSurgery PhysicianMD11248TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24148640OTHERTNBCBS OF TN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316993298
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FREDERICK MYERS M.D.
Provider Business Mailing Address
First Line : PO BOX 1869
Second Line :
City : FLETCHER
State : NC
Zip : 28732-1869
Country : US
Telephone Number : 828-687-5616
Fax Number : 828-650-8076
Provider Business Practice Location Address
First Line : 401 TAKOMA AVE
Second Line :
City : GREENEVILLE
State : TN
Zip : 37743-4647
Country : US
Telephone Number : 423-639-2395
Fax Number : 423-636-0487
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 07/08/2015

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