Provider Demographics
NPI:1588195473
Name:MEYERS, JUSTIN (MD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:MEYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 E. FLORENCE BLVD
Mailing Address - Street 2:ATTN: AMANDA GUMP/ HOSPITALIST TEAM
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-2824
Mailing Address - Country:US
Mailing Address - Phone:520-381-6460
Mailing Address - Fax:
Practice Address - Street 1:1800 E. FLORENCE BLVD
Practice Address - Street 2:ATTN: AMANDA GUMP/ HOSPITALIST TEAM
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-2824
Practice Address - Country:US
Practice Address - Phone:520-381-6460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ61045208M00000X, 207R00000X
MN64242207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program