Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD7736 | NV |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD7736 | NV |
NPI | 1669579280 |
---|---|
Provider Name | John Kimberley Meyers |
First Address | Elko, NV 89801 |
Second Address | Elko, NV 89801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D25064 | (02) | |
R2425 | ANTHEM BLUE CROSS (01) |