Provider Demographics
NPI:1578754289
Name:MYERS, MARCUS L (OD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:L
Last Name:MYERS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MUNCY
Mailing Address - State:PA
Mailing Address - Zip Code:17756-1369
Mailing Address - Country:US
Mailing Address - Phone:570-546-4885
Mailing Address - Fax:570-546-0628
Practice Address - Street 1:112 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MUNCY
Practice Address - State:PA
Practice Address - Zip Code:17756-1369
Practice Address - Country:US
Practice Address - Phone:570-546-4885
Practice Address - Fax:570-546-0628
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001935152W00000X
NY007183152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist