Provider Demographics
NPI:1285611194
Name:MYERS, JAMES O (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:O
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1020 29TH ST
Mailing Address - Street 2:#350 SACRAMENTO COLON & RECTAL SURGERY MEDICAL GRP INC
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5125
Mailing Address - Country:US
Mailing Address - Phone:916-231-1054
Mailing Address - Fax:916-231-1055
Practice Address - Street 1:6450 COYLE AVE
Practice Address - Street 2:#2
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0305
Practice Address - Country:US
Practice Address - Phone:916-966-6121
Practice Address - Fax:916-966-3565
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2010-07-28
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Provider Licenses
StateLicense IDTaxonomies
CAG62722208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ26720ZMedicare ID - Type Unspecified
00G627220Medicare PIN
E39096Medicare UPIN