Provider Demographics
NPI:1346306941
Name:MYERS, TERRI L (MD)
Entity Type:Individual
Prefix:MS
First Name:TERRI
Middle Name:L
Last Name:MYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 BOX BUTTE AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-4445
Mailing Address - Country:US
Mailing Address - Phone:308-762-2534
Mailing Address - Fax:
Practice Address - Street 1:2091 BOX BUTTE AVE STE 500
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-4456
Practice Address - Country:US
Practice Address - Phone:308-762-2534
Practice Address - Fax:308-762-2764
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23534208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice