Provider Demographics
NPI:1164151569
Name:MYERS, PEYTON LEE (OD)
Entity Type:Individual
Prefix:
First Name:PEYTON
Middle Name:LEE
Last Name:MYERS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 CIMMARON DR
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:IA
Mailing Address - Zip Code:50201-2285
Mailing Address - Country:US
Mailing Address - Phone:515-509-6319
Mailing Address - Fax:
Practice Address - Street 1:915 ROBINS SQUARE DR
Practice Address - Street 2:
Practice Address - City:ROBINS
Practice Address - State:IA
Practice Address - Zip Code:52328-9649
Practice Address - Country:US
Practice Address - Phone:319-294-8888
Practice Address - Fax:319-294-4299
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA114562152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist