Individual
DR. CLINTON FRANKLIN MERRILL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15 SHRINE CLUB RD, LANDER, WY 82520-8501
(307) 332-0324
(307) 332-0382
Mailing address
15 SHRINE CLUB RD, LANDER, WY 82520-8501
(307) 332-0324
(307) 332-0382
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
3277A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025668100
—
NE
05
—
141495000
—
WY
01
—
311538
BCBS
WY
01
—
3277A
WYOMING MEDICAL LICENSE
WY
05
—
63235552
—
CO
01
—
W27189
MEDICARE PTAN (WY)
WY
Enumeration date
06/01/2005
Last updated
03/09/2016
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