Provider Demographics
NPI:1063577898
Name:MYERS, BEVERLY MARGARET (DPH)
Entity type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:MARGARET
Last Name:MYERS
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 E 97TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-5009
Mailing Address - Country:US
Mailing Address - Phone:918-299-6728
Mailing Address - Fax:918-299-7185
Practice Address - Street 1:262 E. 141ST ST.
Practice Address - Street 2:
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033-3118
Practice Address - Country:US
Practice Address - Phone:918-322-3667
Practice Address - Fax:918-322-5923
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9149183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist