Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 26837 | MS |
NPI | 1003254525 |
---|---|
Provider Name | Philip D Myers |
First Address | Gulfport, MS 39503-3485 |
Second Address | Gulfport, MS 39503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2013 |
Last Update Date | 17/07/2019 |