Provider Demographics
NPI:1841281607
Name:MYERS, JULIA CHRISTINE (MD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:CHRISTINE
Last Name:MYERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIA
Other - Middle Name:CHRISTINE
Other - Last Name:WATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:RR 2 BOX 38
Mailing Address - Street 2:211 EAST EARL ST
Mailing Address - City:LEOTI
Mailing Address - State:KS
Mailing Address - Zip Code:67861-9504
Mailing Address - Country:US
Mailing Address - Phone:620-375-2233
Mailing Address - Fax:620-375-2646
Practice Address - Street 1:RR 2 BOX 38
Practice Address - Street 2:211 EAST EARL ST
Practice Address - City:LEOTI
Practice Address - State:KS
Practice Address - Zip Code:67861-9504
Practice Address - Country:US
Practice Address - Phone:620-375-2233
Practice Address - Fax:620-375-2646
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04 29417207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100402090FMedicaid
KS104279OtherBC BS
KS104279OtherBC BS
D87739Medicare UPIN