Individual
BARRY A MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-2848
(317) 962-3916
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003966A
IN
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
PA.0007212
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1101994107
ANTHEM PTAN
IN
05
—
300073349
—
IN
Enumeration date
08/11/2020
Last updated
02/14/2025
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