Merrell, Marshall H

Merrell, Marshall H is an individual health care provider with primary practice located at 46 Professional Plz , Rexburg ID 83440-2047. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Merrell, Marshall H can be contacted via phone (208) 359-2020.

Contact Information

Primary practice address
46 Professional Plz Rexburg ID 83440-2047
Phone: (208) 359-2020
Fax: (208) 359-2021
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP813 Idaho

Profile Details

NPI number 1992894232
LBN Legal business name Merrell, Marshall H
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Mar 20th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992894232 NPPES
Idaho Other 000010015276 REGENCE BLUE SHIELD
Idaho Other V7261 REGENCE BLUE SHIELD
Idaho MEDICAID 002652200 REGENCE BLUE SHIELD
Idaho Other 000010015275 REGENCE BLUE SHIELD
Idaho Other V3058 REGENCE BLUE SHIELD

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