Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | SC531 | SC |
N | 213E00000X | Podiatrist | SC531 | SC |
N | 222Z00000X | Podiatrist | SC531 | SC |
Y | 213EP1101X | Primary Podiatric Medicine | SC531 | SC |
N | 213ES0103X | Foot & Ankle Surgery | SC531 | SC |
N | 213ES0131X | Foot Surgery | SC 531 | SC |
NPI | 1457316861 |
---|---|
Provider Name | Dr. William Charles Myers JR. |
First Address | Conway, SC 29526-8964 |
Second Address | Conway, SC 29526-8964 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 05/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PD5319 | (05) | SC |
U76757 | (02) | SC |