Provider Demographics
NPI:1336180082
Name:MYERS, PHILIP F JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:F
Last Name:MYERS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2601 MISSION POINT BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-6600
Mailing Address - Country:US
Mailing Address - Phone:937-912-4441
Mailing Address - Fax:937-429-4236
Practice Address - Street 1:4164 BURBANK RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-9077
Practice Address - Country:US
Practice Address - Phone:330-345-8032
Practice Address - Fax:330-345-8072
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2012-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.039262207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0335060Medicaid
OH0335060Medicaid
OHA82986Medicare UPIN