MEDICARE: DR. LISA C MYERS 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	207Q00000X	Family Medicine Physician	OS009023L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	878849	OTHER	PA	BLUE SHIELD
2	50000818	OTHER		CAP BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598742025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA C MYERS DO

Provider Business Mailing Address
First Line	:	850 WALNUT BOTTOM RD
Second Line	:	SUITE 305
City	:	CARLISLE
State	:	PA
Zip	:	17013-3632
Country	:	US
Telephone Number	:	717-960-0052
Fax Number	:	717-960-0055

Provider Business Practice Location Address
First Line	:	103 N BALTIMORE AVE
Second Line	:
City	:	MOUNT HOLLY SPRINGS
State	:	PA
Zip	:	17065-1202
Country	:	US
Telephone Number	:	717-960-0052
Fax Number	:	717-960-0055

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

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	05/16/2024

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