Basic Information
Provider Information
NPI: 1780671784
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MYERS
FirstName: FRANKLIN
MiddleName: J
NamePrefix: DR.
NameSuffix: III
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1631 N FRONT ST
Address2:  
City: HARRISBURG
State: PA
PostalCode: 171022435
CountryCode: US
TelephoneNumber: 7172342561
FaxNumber: 7172361121
Practice Location
Address1: 1631 N FRONT ST
Address2:  
City: HARRISBURG
State: PA
PostalCode: 171022435
CountryCode: US
TelephoneNumber: 7172342561
FaxNumber: 7172361121
Other Information
ProviderEnumerationDate: 10/04/2005
LastUpdateDate: 02/25/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XMD012697EPAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

ID Information
IDTypeStateIssuerDescription
000777200000105PA MEDICAID


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