Provider Demographics
NPI:1083382261
Name:MYERS SURGICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:MYERS SURGICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ORRINGTON-MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:804-445-3633
Mailing Address - Street 1:5401 TOTTENHAM CIR
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-9442
Mailing Address - Country:US
Mailing Address - Phone:812-814-3417
Mailing Address - Fax:
Practice Address - Street 1:4445 S 10TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4315
Practice Address - Country:US
Practice Address - Phone:812-814-3417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty