Provider Demographics
NPI:1881661585
Name:MYERS, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:MYERS
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 1:5150 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2030
Mailing Address - Country:US
Mailing Address - Phone:850-476-6759
Mailing Address - Fax:850-484-5222
Practice Address - Street 1:5150 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2030
Practice Address - Country:US
Practice Address - Phone:850-476-6759
Practice Address - Fax:850-484-5222
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89738207W00000X, 207WX0107X
ALMD.25817207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009933353Medicaid
4968898OtherCIGNA
7261366OtherAETNA
FLC939OtherWELLCARE
FLME89738OtherMEDICAL LICENSE
AL009933357Medicaid
AL009993705Medicaid
AL059172116OtherBCBS
TN1330323OtherBCBS
FL37944OtherBCBS
ALMD.25817OtherMEDICAL LICENSE
AL009933376Medicaid
AL009933379Medicaid
FL270262200Medicaid
AL009933378Medicaid
ALH70763OtherTHE OATH-HEALTHPLAN OF AL
AL009933353Medicaid
AL009933357Medicaid
AL059172116OtherBCBS
FLME89738OtherMEDICAL LICENSE