MEDICARE: THE MYERS FOUNDATION CHRISTIAN FAMILY HEALTH CENTERS

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	174400000X	Specialist	11615	MS

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

General Provider Information

NPI Number	:	1992946263
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MYERS FOUNDATION CHRISTIAN FAMILY HEALTH CENTERS

Provider Business Mailing Address
First Line	:	PO BOX 637
Second Line	:
City	:	TCHULA
State	:	MS
Zip	:	39169-0637
Country	:	US
Telephone Number	:	662-235-4227
Fax Number	:	662-247-4767

Provider Business Practice Location Address
First Line	:	15548 HWY. 49 EAST
Second Line	:	SUITE A
City	:	TCHULA
State	:	MS
Zip	:	39169
Country	:	US
Telephone Number	:	662-235-4227
Fax Number	:	662-247-4767

Authorized Official
Title or Position	:	FOUNDER/PRESIDENT
Name	:	DR. RONALD V MYERS SR.
Credential	:	M.D.
Telephone Number	:	662-235-4227

Provider Enumeration Date	:	03/17/2009
Last Update Date	:	03/17/2009

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