MEDICARE: DOUGLAS H. MEYER, D.C. P.C.

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	111N00000X	Chiropractor	006770	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000014869	OTHER	MO	MEDICARE LEGACY #

General Provider Information

NPI Number	:	1417143355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOUGLAS H. MEYER, D.C. P.C.

Provider Business Mailing Address
First Line	:	601A MARKET ST
Second Line	:
City	:	HERMANN
State	:	MO
Zip	:	65041-1351
Country	:	US
Telephone Number	:	573-486-3888
Fax Number	:

Provider Business Practice Location Address
First Line	:	601A MARKET ST
Second Line	:
City	:	HERMANN
State	:	MO
Zip	:	65041-1351
Country	:	US
Telephone Number	:	573-486-3888
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DOUGLAS H MEYER
Credential	:	D.C.
Telephone Number	:	573-486-3888

Provider Enumeration Date	:	09/24/2007
Last Update Date	:	02/05/2013

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