Provider Demographics
NPI:1770576308
Name:MYERS, ROBIN S (DPM)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:S
Last Name:MYERS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 N VIA AVELLANA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-7267
Mailing Address - Country:US
Mailing Address - Phone:520-615-9877
Mailing Address - Fax:520-615-9877
Practice Address - Street 1:3915 N VIA AVELLANA
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-7267
Practice Address - Country:US
Practice Address - Phone:520-615-9877
Practice Address - Fax:520-615-9877
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0596213EP1101X
TX1521213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU81973Medicare UPIN
AZZ107119Medicare PIN