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General NPI Number Information
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NPI Number | 1992707285
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Entity Type | Individual
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Provider Name | CLINTON FRANKLIN MERRILL JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 03/09/2016
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Provider Practice Location Address
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Address Line | 15 SHRINE CLUB RD
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City | LANDER
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State | WY
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Zip | 82520-8501
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Country | US
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Telephone | 307-332-0324
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Fax | 307-332-0382
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Provider Business Mailing Address
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Address Line | 15 SHRINE CLUB RD
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City | LANDER
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State | WY
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Zip | 82520-8501
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Country | US
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Telephone | 307-332-0324
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Fax | 307-332-0382
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 3277A
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License Number State | WY
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