Individual
NATHANIEL LOGAN MYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-6863
Mailing address
6205 WILLIAMSBURG WAY APT 102, DEFOREST, WI 53532-9123
(937) 728-1860
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
190-17
WI
367H00000X
Anesthesiologist Assistant
Primary
190-17
WI
367H00000X
Anesthesiologist Assistant
2024036980
MO
Other
Enumeration date
06/11/2021
Last updated
04/09/2026
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