Individual
JOHNNY W MYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 W MAIN ST, NEW LEBANON, OH 45345-9172
(937) 687-1911
(937) 687-1888
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8493
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.426759
OH
363LF0000X
Family Nurse Practitioner
Primary
LE-00029703
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0372742
—
OH
Enumeration date
08/20/2019
Last updated
01/11/2021
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