Provider Demographics
NPI:1437114584
Name:MYERS, PHILIP L JR (PA-C)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:L
Last Name:MYERS
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-264-3644
Mailing Address - Fax:717-264-9077
Practice Address - Street 1:3106 PHILADELPHIA AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-8938
Practice Address - Country:US
Practice Address - Phone:717-264-3644
Practice Address - Fax:717-264-9077
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002395-L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
867633OtherMEDICARE GROUP #
867633OtherMEDICARE GROUP #
PAS52293Medicare UPIN
PAMY006826Medicare ID - Type Unspecified
PA006826FSCMedicare PIN