Mid County OB GYN Group, Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

MID COUNTY OB GYN GROUP, INC

Practice address

11652 Studt Ave
Saint Louis, MO 63141-7025

Phone

(314) 395-3163

Fax

(314) 991-5447

NPI assigned

Nov 28, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ivan Talley Myers, MD

Title

MD Physician

Phone

(314) 395-3163

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1265508600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11652 STUDT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417025",
            "telephone_number": "314-395-3163",
            "fax_number": "314-991-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11652 STUDT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417025",
            "telephone_number": "314-395-3163",
            "fax_number": "314-991-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID COUNTY OB GYN GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "TALLEY",
        "authorized_official_title_or_position": "MD PHYSICIAN",
        "authorized_official_telephone_number": "314-395-3163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207881301",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.