Provider Demographics
NPI:1407290927
Name:MYERS, RICHARD (DVM)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:MYERS
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4158 WESTPORT RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-2723
Mailing Address - Country:US
Mailing Address - Phone:502-897-1000
Mailing Address - Fax:502-896-5822
Practice Address - Street 1:4158 WESTPORT RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-2723
Practice Address - Country:US
Practice Address - Phone:502-897-1000
Practice Address - Fax:502-896-5822
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYNS2469174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYNS2469OtherVETERINARIAN