person
Clyde Edward Merrill, PA-C
Surgical Physician Assistant in Gilbert, Arizona
NPI 1497910533

Clyde Edward Merrill is a Surgical Physician Assistant based in Gilbert, AZ and is specialized in Surgical. Clyde Edward Merrill practices in Gilbert, AZ and has the professional credentials of PA-C. The NPI Number for Clyde Edward Merrill is 1497910533 and holds a License No. 01203 (Arizona).

The current practice location address for Clyde Edward Merrill is 2946 E Banner Gateway Dr, Gilbert, AZ and can be reached out via phone at 480-256-6444 and via fax at 480-256-4734.

Location: 2946 E Banner Gateway Dr, Gilbert, AZ, 85234
person
Provider Profile Details
NPI Number
1497910533
Provider Name
Clyde Edward Merrill
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
2946 E Banner Gateway Dr, Gilbert, AZ, 85234
Phone Number
480-256-6444
Fax Number
480-256-4734
Provider Enumeration Date
07/28/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0070594 05 OH
01203 01 WV WV LICENSE
000000723364 01 OH ANTHEM
000000635240 01 OH ANTHEM
institution
Provider Business Practice Location Address Details
Address
2946 E Banner Gateway Dr
City
State
Zip
85234-2165
Phone Number
480-256-6444
Fax Number
480-256-4734
person
Provider Business Mailing Address Details
Address
2946 E Banner Gateway Dr
City
State
Zip
85234-2165
Phone Number
480-256-6444
Fax Number
480-256-4734
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
01203 (West Virginia)
Definition
Definition to come...
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