Provider Demographics
NPI:1942271366
Name:MYERS, TAMI R (PA-C)
Entity Type:Individual
Prefix:MS
First Name:TAMI
Middle Name:R
Last Name:MYERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:TAMI
Other - Middle Name:R
Other - Last Name:MEISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3400 W TECUMSEH RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-1810
Mailing Address - Country:US
Mailing Address - Phone:405-360-6764
Mailing Address - Fax:405-360-6769
Practice Address - Street 1:608 NW 9TH ST
Practice Address - Street 2:SUITE 6000
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1068
Practice Address - Country:US
Practice Address - Phone:405-360-6764
Practice Address - Fax:405-360-6769
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1038363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP00282132OtherRAILROAD MEDICARE
OKP14674Medicare UPIN
OKP00282132OtherRAILROAD MEDICARE
OKOK700060Medicare PIN