Basic Information
Provider Information
NPI: 1518946581
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEYERING
FirstName: CHRISTOPHER
MiddleName: DAVID
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 W HOSPITAL RD
Address2: FAMILY MEDICINE CLINIC
City: FORT GORDON
State: GA
PostalCode: 309055650
CountryCode: US
TelephoneNumber: 7067879355
FaxNumber: 7067879356
Practice Location
Address1: 300 W HOSPITAL RD
Address2: FAMILY MEDICINE CLINIC
City: FORT GORDON
State: GA
PostalCode: 309055650
CountryCode: US
TelephoneNumber: 7067879355
FaxNumber: 7067879356
Other Information
ProviderEnumerationDate: 01/10/2006
LastUpdateDate: 10/08/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207QS0010X61607GAY Allopathic & Osteopathic PhysiciansFamily MedicineSports Medicine

No ID Information.


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