Organization
KENT W. MYERS, MD, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL M SHANAHAN (BILLING MANAGER)
(623) 974-6611
Entity
Organization
Contact information
Practice address
9965 W ROYAL OAK RD, SUITE # 2236, SUN CITY, AZ 85351-6109
(623) 815-0210
(623) 815-0212
Mailing address
9965 W ROYAL OAK RD, SUITE # 2236, SUN CITY, AZ 85351-6109
(623) 815-0210
(623) 815-0212
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19579
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508813965
INDIVIDUAL NPI
AZ
Enumeration date
08/16/2011
Last updated
08/16/2011
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