Individual
JEFFREY R MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1019 W OAKLAND AVE, SUITE 1, JOHNSON CITY, TN 37604-2357
(423) 915-5000
(423) 915-5045
Mailing address
PO BOX 3700, JOHNSON CITY, TN 37602-3700
(423) 952-2122
(423) 952-2145
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD30902
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669438784
—
VA
05
—
3858149
—
TN
Enumeration date
04/26/2006
Last updated
06/22/2015
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