Individual
MR. JOEL MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
17054 INDIO RD #4931, BEND, OR 97707
(541) 203-3110
Mailing address
PO BOX 4931, BEND, OR 97707-4931
(541) 203-3110
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
PA01053
OR
207Q00000X
Family Medicine Physician
PA01053
OR
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500606276
—
OR
01
—
MY1970
NEP
—
Enumeration date
06/27/2006
Last updated
04/27/2023
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