Basic Information
| Provider Information | |||||||||
| NPI: | 1598977373 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MYERS | ||||||||
| FirstName: | JODEE | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | S.A.-C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 79680 LAMBORN RD | ||||||||
| Address2: | |||||||||
| City: | CADIZ | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439079445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405464449 | ||||||||
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| Practice Location | |||||||||
| Address1: | 951 E MARKET ST | ||||||||
| Address2: | |||||||||
| City: | CADIZ | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439079799 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7409424631 | ||||||||
| FaxNumber: | 7409422749 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2007 | ||||||||
| LastUpdateDate: | 11/10/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.