Individual
JACOB JEFFREY MERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
419 S WASHINGTON ST STE 101, CASPER, WY 82601-2991
(307) 265-1620
(307) 237-1074
Mailing address
419 S WASHINGTON ST STE 101, CASPER, WY 82601-2991
(307) 265-1620
(307) 237-1074
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
80403
MT
2085R0202X
Diagnostic Radiology Physician
Primary
9878A
WY
2085R0202X
Diagnostic Radiology Physician
CDR.0000559
CO
Other
Enumeration date
04/21/2009
Last updated
06/17/2024
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