Provider Demographics
NPI:1770562225
Name:MYERS, JANET K (DO)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:K
Last Name:MYERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 S BUSINESS 61
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:MO
Mailing Address - Zip Code:63334-5239
Mailing Address - Country:US
Mailing Address - Phone:573-324-2063
Mailing Address - Fax:573-324-2167
Practice Address - Street 1:710 S BUSINESS HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:MO
Practice Address - Zip Code:63334-5239
Practice Address - Country:US
Practice Address - Phone:573-324-2063
Practice Address - Fax:573-324-2167
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1F20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO242157527Medicaid
MO002013771Medicare ID - Type Unspecified
MO242157527Medicaid