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Individual

ROBERT KEMP MYERS SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
913 N DIXIE AVE, ELIZABETHTOWN, KY 42701-2503
(270) 706-1651
(270) 706-1058
Mailing address
PO BOX 2119, ELIZABETHTOWN, KY 42702-2119
(270) 351-2671

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
17208
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000518773
ANTHEM BCBS
KY
01
2843002000
PASSPORT ADVANTAGE
KY
01
4054074
CIGNA
KY
01
50014791
PASSPORT
KY
05
64172083
KY
Enumeration date
07/12/2006
Last updated
11/16/2007
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