Provider Demographics
NPI:1275508590
Name:MYERS, JOHN A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20 PROGRESS POINT PKWY
Mailing Address - Street 2:STE 22
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-2206
Mailing Address - Country:US
Mailing Address - Phone:636-344-3333
Mailing Address - Fax:636-344-3334
Practice Address - Street 1:20 PROGRESS POINT PKWY
Practice Address - Street 2:STE 22
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-2206
Practice Address - Country:US
Practice Address - Phone:636-344-3333
Practice Address - Fax:636-344-3334
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2021-11-29
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Provider Licenses
StateLicense IDTaxonomies
MO112791208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200026271Medicaid