Provider Demographics
NPI:1912201260
Name:DAVID PAUL MYERS, D.O., P.C.
Entity Type:Organization
Organization Name:DAVID PAUL MYERS, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:520-790-2798
Mailing Address - Street 1:750 S CRAYCROFT RD STE 150
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-7132
Mailing Address - Country:US
Mailing Address - Phone:520-790-2798
Mailing Address - Fax:520-745-6260
Practice Address - Street 1:750 S CRAYCROFT RD STE 150
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-7132
Practice Address - Country:US
Practice Address - Phone:520-790-2798
Practice Address - Fax:520-745-6260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1575208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD47301Medicare UPIN