Provider Demographics
NPI:1801848247
Name:MEYERS, STEPHEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:C
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 1:311 E SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5614
Mailing Address - Country:US
Mailing Address - Phone:620-275-3700
Mailing Address - Fax:620-275-3717
Practice Address - Street 1:311 E SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5614
Practice Address - Country:US
Practice Address - Phone:620-275-3700
Practice Address - Fax:620-275-3717
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-17039208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSE52400Medicare UPIN
KS103761Medicare PIN