Provider Demographics
NPI:1023156510
Name:MEYER, ROY PHILLIP (DC)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:PHILLIP
Last Name:MEYER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 W CAPE ROCK DR
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701
Mailing Address - Country:US
Mailing Address - Phone:573-334-9445
Mailing Address - Fax:
Practice Address - Street 1:73 SHERIDAN
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-5936
Practice Address - Country:US
Practice Address - Phone:573-651-3535
Practice Address - Fax:573-651-3565
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO10330OtherBLUE CROSS
MO397874OtherHEALTHLINK
MO30855Medicare ID - Type Unspecified
T43378Medicare UPIN