Healthcare Provider Details

I. General information

NPI: 1114842754
Provider Name (Legal Business Name): R MCKAY MERRILL OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1181 N DAL PASO ST
HOBBS NM
88240
US

IV. Provider business mailing address

1181 N DAL PASO ST
HOBBS NM
88240
US

V. Phone/Fax

Practice location:
  • Phone: 575-397-3611
  • Fax:
Mailing address:
  • Phone: 575-397-3611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT-2026-0016
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: