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Individual

DR. BRANDON CHARLES MERRILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3317 N WIMBERLY DR, FAYETTEVILLE, AR 72703-4056
(479) 521-2752
(479) 521-4603
Mailing address
3317 N WIMBERLY DR, FAYETTEVILLE, AR 72703-4056
(479) 521-2752
(479) 521-4603

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
PA-1022
AR
363A00000X
Physician Assistant
Primary
PA-1022
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1679957369
MO
Enumeration date
07/13/2015
Last updated
03/05/2024
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