Individual
EVAN CHARD MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1904 E BARNETT RD, MEDFORD, OR 97504-8262
(541) 776-3338
(541) 776-4979
Mailing address
1904 E BARNETT RD, MEDFORD, OR 97504-8262
(541) 776-3338
(541) 776-4979
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
DP00312
OR
213ES0131X
Foot Surgery Podiatrist
Primary
DP00312
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
297199
—
OR
01
—
891269001
BLUE CROSS PROVIDER NUMBE
OR
Enumeration date
09/21/2006
Last updated
09/16/2020
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