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Individual

LARRY MYERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
25919 HIGHWAY 36, CHESHIRE, OR 97419-9745
(541) 870-1151
Mailing address
25919 HIGHWAY 36, CHESHIRE, OR 97419-9745
(541) 870-1151

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD21360
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
227624
OR
Enumeration date
09/22/2006
Last updated
04/28/2015
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