| Jordan W Merrill, MD | |
|
1032 S. Bridgeway Pl., Ste 110, Eagle, ID 83616 | |
| (208) 475-0800 | |
| (208) 639-0901 |
| Full Name | Jordan W Merrill |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1032 S. Bridgeway Pl., Eagle, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902197007 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | M-13001 (Idaho) | Primary |
| Entity Name | University of Utah Behavioral Health Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740688613 PECOS PAC ID: 9537483607 Enrollment ID: O20150120001118 |
| Entity Name | University of Utah Acuity Care Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407250541 PECOS PAC ID: 4789908534 Enrollment ID: O20150127000392 |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan W Merrill, MD 1032 S. Bridgeway Pl., Ste 110, Eagle, ID 83616 Ph: (208) 475-0800 | Jordan W Merrill, MD 1032 S. Bridgeway Pl., Ste 110, Eagle, ID 83616 Ph: (208) 475-0800 |
Renae Ramos, PA-C Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1032 S Bridgeway Pl, Eagle, ID 83616 Phone: 208-246-0123 |
Dr. Grant B Belnap, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1032 S Bridge Way Pl, Suite 100, Eagle, ID 83616 Phone: 208-246-0123 Fax: 208-246-0125 |