Provider Demographics
NPI:1023088770
Name:MYERS, CHRISTOPHER BLAKE (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:BLAKE
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4045 MOUNT WHITNEY WAY
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-5131
Mailing Address - Country:US
Mailing Address - Phone:864-380-7823
Mailing Address - Fax:
Practice Address - Street 1:3190 CHURN CREEK RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2122
Practice Address - Country:US
Practice Address - Phone:530-223-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV29367207W00000X
CAG178560207W00000X
SC14023207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC180018442OtherMEDICARE RAILROAD
SC140234Medicaid
SC1577695003OtherCIGNA PROVIDER NUMBER
SC4328801OtherAETNA PROVIDER NUMBER