Provider Demographics
NPI:1982650610
Name:ALLEN BAILE MYERS,D.O.
Entity Type:Organization
Organization Name:ALLEN BAILE MYERS,D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:BAILE
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-532-2244
Mailing Address - Street 1:515 CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19074-1416
Mailing Address - Country:US
Mailing Address - Phone:610-532-2244
Mailing Address - Fax:610-532-0186
Practice Address - Street 1:515 CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:PA
Practice Address - Zip Code:19074-1416
Practice Address - Country:US
Practice Address - Phone:610-532-2244
Practice Address - Fax:610-532-0186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002213L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAD66294Medicare UPIN
MY41611Medicare ID - Type Unspecified