Provider Demographics
NPI:1083703904
Name:MYEARS, DONALD W (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:W
Last Name:MYEARS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2115 S FREMONT AVE
Mailing Address - Street 2:SUITE 4300
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804
Mailing Address - Country:US
Mailing Address - Phone:417-820-3911
Mailing Address - Fax:
Practice Address - Street 1:1900 S NATIONAL AVE
Practice Address - Street 2:SUITE 3600
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2265
Practice Address - Country:US
Practice Address - Phone:417-820-3911
Practice Address - Fax:417-820-3924
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR1F89207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202643938Medicaid
MO202643938Medicaid
MO063013268Medicare PIN
MOE55189Medicare UPIN