Provider Demographics
NPI:1831105022
Name:MYSKIW, JOHN ERIC (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ERIC
Last Name:MYSKIW
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2772 MAPLEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-1417
Mailing Address - Country:US
Mailing Address - Phone:785-539-7299
Mailing Address - Fax:
Practice Address - Street 1:IRWIN ARMY COMMUNITY HOSPITAL
Practice Address - Street 2:600 CAISSON HILL ROAD,
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-5037
Practice Address - Country:US
Practice Address - Phone:785-239-7155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant