Provider Demographics
NPI:1477509701
Name:MYERS, DAVID SCOTT (DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOTT
Last Name:MYERS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8059 MITCHELL LN
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-6821
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1514 DECATUR PIKE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-2422
Practice Address - Country:US
Practice Address - Phone:423-212-3310
Practice Address - Fax:423-212-3312
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT5746225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5441649Medicaid
TN0446652Medicaid
TN3156797OtherBCBST - GROUP NUMBER
TN3156797OtherBCBST - GROUP NUMBER
TN0446652Medicaid
TN446652Medicare ID - Type UnspecifiedGROUP NUMBER