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Individual

JOHN CARLTON MYERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1340 CHARLES ST STE 300, ROCKFORD, IL 61104-2200
(779) 696-8800
Mailing address
PO BOX 1567, ROCKFORD, IL 61110-0067

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036095491
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036095491
IL
05
32318300
WI
Enumeration date
07/03/2006
Last updated
11/11/2013
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