Provider Demographics
NPI:1700052123
Name:MYO, GEORGE K (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:K
Last Name:MYO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2161 E PECOS RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-6131
Mailing Address - Country:US
Mailing Address - Phone:602-753-2663
Mailing Address - Fax:480-247-2479
Practice Address - Street 1:2161 E PECOS RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-6131
Practice Address - Country:US
Practice Address - Phone:602-753-2663
Practice Address - Fax:480-247-2479
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ42034207X00000X, 207XP3100X, 207XS0106X, 207XS0114X, 207XX0004X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma