Individual
MERRILL A THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
46 E 15TH ST, EDMOND, OK 73013-4301
(316) 214-6269
(405) 341-7074
Mailing address
46 E 15TH ST, EDMOND, OK 73013-4301
(316) 214-6269
(405) 341-7074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2003
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100234950C
—
KS
01
—
102870
BCBS
KS
01
—
1447
PHS
KS
01
—
167043
COVENTRY
KS
01
—
300567
HPK
KS
Enumeration date
06/28/2006
Last updated
06/04/2015
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