Individual
BRIAN LONGHURST MERRILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 POLK COUNTY PLZ STE 180, BALSAM LAKE, WI 54810-8009
(715) 485-8876
Mailing address
1300 N 500 E, SUITE 330, LOGAN, UT 84341-2408
(435) 716-5790
(435) 716-2921
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1851-321
WI
2084P0800X
Psychiatry Physician
4993153
UT
2084P0800X
Psychiatry Physician
73041
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107012431102
SELECTHEALTH
UT
01
—
200521603
FIRSTHEALTH
UT
01
—
200521603BM2
EMIA
UT
01
—
49931531200001
BCBS OF UT
UT
01
—
751650
DMBA
UT
01
—
79126
PEHP
UT
Enumeration date
06/16/2006
Last updated
03/01/2023
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