MEDICARE: MS. TAMI R MYERS PA-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	363A00000X	Physician Assistant	1038	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00282132	OTHER	OK	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1942271366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TAMI R MYERS PA-C

Provider Business Mailing Address
First Line	:	3400 W TECUMSEH RD
Second Line	:	SUITE 101
City	:	NORMAN
State	:	OK
Zip	:	73072-1810
Country	:	US
Telephone Number	:	405-360-6764
Fax Number	:	405-360-6769

Provider Business Practice Location Address
First Line	:	608 NW 9TH ST
Second Line	:	SUITE 6000
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-1068
Country	:	US
Telephone Number	:	405-360-6764
Fax Number	:	405-360-6769

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

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	09/24/2012

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