Healthcare Provider Details

I. General information

NPI: 1871702464
Provider Name (Legal Business Name): DENNIS WILLIAM MERSKI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1589 SPARTA ST STE 104
MCMINNVILLE TN
37110-1392
US

IV. Provider business mailing address

300 20TH AVE N STE 403
NASHVILLE TN
37203-5180
US

V. Phone/Fax

Practice location:
  • Phone: 931-473-4714
  • Fax: 931-815-5060
Mailing address:
  • Phone: 615-284-4088
  • Fax: 615-284-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number2209
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34.011034
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: