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NPI Code Detail

MEDICARE: ARTHUR NELSON MERRELL MD

MEDICARE: ARTHUR NELSON MERRELL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician2361AWY
22084P0802XAddiction Psychiatry Physician2361AWY
32084F0202XForensic Psychiatry Physician2361AWY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1260012308OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2305052OTHERWYBLUE SHIELD

General Provider Information

NPI Number : 1356340855
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARTHUR NELSON MERRELL MD
Provider Business Mailing Address
First Line : 2526 SEYMOUR AVE
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-3159
Country : US
Telephone Number : 307-634-9653
Fax Number : 307-638-8256
Provider Business Practice Location Address
First Line : 2526 SEYMOUR AVE
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-3159
Country : US
Telephone Number : 307-634-9653
Fax Number : 307-638-8256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2005
Last Update Date : 03/14/2011

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1134129554 — MS. NATALIE JEAN MILLIGAN MS LPC LAT
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