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NPI Code Detail

MEDICARE: BRAD A MYERS MD

MEDICARE: BRAD A MYERS MD
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 Physician1845531205UT

General Provider Information

NPI Number : 1700986635
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRAD A MYERS MD
Provider Business Mailing Address
First Line : 1490 E FOREMASTER DR STE 200
Second Line :
City : ST GEORGE
State : UT
Zip : 84790-4496
Country : US
Telephone Number : 435-628-1641
Fax Number : 435-628-1660
Provider Business Practice Location Address
First Line : 1490 E FOREMASTER DR STE 200
Second Line :
City : ST GEORGE
State : UT
Zip : 84790-4496
Country : US
Telephone Number : 435-628-1641
Fax Number : 435-628-1660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 06/17/2013

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Directions to “ BRAD A MYERS MD” Practice Location

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