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NPI Code Detail

MEDICARE: DR. JAMIE MYERS OD

MEDICARE:  DR. JAMIE  MYERS  OD
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
1152W00000XOptometrist3816WI

General Provider Information

NPI Number : 1932820123
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMIE MYERS OD
Provider Business Mailing Address
First Line : 3142 N RICHMOND ST
Second Line :
City : APPLETON
State : WI
Zip : 54911-1151
Country : US
Telephone Number : 321-246-5376
Fax Number :
Provider Business Practice Location Address
First Line : 3142 N RICHMOND ST
Second Line :
City : APPLETON
State : WI
Zip : 54911-1151
Country : US
Telephone Number : 920-499-3102
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2022
Last Update Date : 09/07/2022

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Directions to “ DR. JAMIE MYERS OD” Practice Location

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