Provider Demographics
NPI:1811948649
Name:MYERS, JOHN A (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:14100 E ARAPAHOE RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4028
Mailing Address - Country:US
Mailing Address - Phone:303-493-1922
Mailing Address - Fax:303-493-1926
Practice Address - Street 1:14100 E ARAPAHOE RD
Practice Address - Street 2:SUITE 211
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4028
Practice Address - Country:US
Practice Address - Phone:303-493-1922
Practice Address - Fax:303-493-1926
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO242602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01242601Medicaid
800533Medicare ID - Type Unspecified
CO01242601Medicaid