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NPI Code Detail

MEDICARE: RICHARD L MERKLEY MD PC

MEDICARE: RICHARD L MERKLEY MD PC
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
1207Q00000XFamily Medicine Physician14862AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ0426790OTHERAZBCBS AZ

General Provider Information

NPI Number : 1811228661
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHARD L MERKLEY MD PC
Provider Business Mailing Address
First Line : 2530 E SOUTHERN AVE
Second Line :
City : MESA
State : AZ
Zip : 85204-5411
Country : US
Telephone Number : 480-892-2323
Fax Number : 480-892-3339
Provider Business Practice Location Address
First Line : 2530 E SOUTHERN AVE
Second Line :
City : MESA
State : AZ
Zip : 85204-5411
Country : US
Telephone Number : 480-892-2323
Fax Number : 480-892-3339
Authorized Official
Title or Position : OFFICE MANAGER
Name : DIANE M MORRIS
Credential :
Telephone Number : 480-892-2323
Provider Enumeration Date : 01/19/2010
Last Update Date : 01/19/2010

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