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1831180546

NPI Code Detail

MEDICARE: SAMUEL E MYRICK III MD

MEDICARE: SAMUEL E MYRICK III 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
1	207RX0202X	Medical Oncology Physician	ME90579	FL
2	207R00000X	Internal Medicine Physician	ME90579	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831180546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL E MYRICK III MD

Provider Business Mailing Address
First Line	:	3130 SW 32ND AVE
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34474-4445
Country	:	US
Telephone Number	:	352-732-4032
Fax Number	:	352-732-4191

Provider Business Practice Location Address
First Line	:	3130 SW 32ND AVE
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34474-4445
Country	:	US
Telephone Number	:	352-732-4032
Fax Number	:	352-732-4191

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	02/27/2023

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Directions to “ SAMUEL E MYRICK III MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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