Individual
DR. JACK DOUGLAS MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
207 2ND AVE SW, MIAMI, OK 74354-6818
(918) 540-7458
Mailing address
PO BOX 844, MIAMI, OK 74355-0844
(918) 540-7458
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1025
OK
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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