Provider Demographics
NPI:1922158385
Name:MEYER, DOUGLAS HAROLD (DC PC)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:HAROLD
Last Name:MEYER
Suffix:
Gender:M
Credentials:DC PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 STATE HIGHWAY 100 W
Mailing Address - Street 2:
Mailing Address - City:HERMANN
Mailing Address - State:MO
Mailing Address - Zip Code:65041-1560
Mailing Address - Country:US
Mailing Address - Phone:573-486-3888
Mailing Address - Fax:
Practice Address - Street 1:196 STATE HIGHWAY 100 W
Practice Address - Street 2:
Practice Address - City:HERMANN
Practice Address - State:MO
Practice Address - Zip Code:65041-1560
Practice Address - Country:US
Practice Address - Phone:573-486-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006770111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO120852OtherBCBS OF MO
MOP00320855OtherRAIL ROAD MEDICARE
MO316864869Medicare ID - Type Unspecified
MO120852OtherBCBS OF MO