Individual
MARK A MYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1741 MIDLAND TRL, SHELBYVILLE, KY 40065-1711
(502) 633-0192
(502) 633-4164
Mailing address
18 VILLAGE PLAZA, PMB 136, SHELBYVILLE, KY 40065-1711
(502) 633-0192
(502) 633-4164
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
32619
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000041773
ANTHEM
KY
01
—
000802487
HUMANA
KY
01
—
1063266
PASSPORT HEALTH PLAN
KY
01
—
122601
CHA
KY
01
—
5134693001
CIGNA
KY
01
—
5344332
AETNA
KY
05
—
64326192
—
KY
01
—
PASSPORT ADVANTAGE
2434349000
KY
Enumeration date
06/13/2005
Last updated
04/19/2019
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