Provider Demographics
NPI:1700890878
Name:MERRICK, JAMES G (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:G
Last Name:MERRICK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:309 COUNTY ROUTE 47
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983-5405
Mailing Address - Country:US
Mailing Address - Phone:518-891-2688
Mailing Address - Fax:518-891-4120
Practice Address - Street 1:309 COUNTY ROUTE 47
Practice Address - Street 2:SUITE 1
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-5405
Practice Address - Country:US
Practice Address - Phone:518-891-2688
Practice Address - Fax:518-891-4120
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2014-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI21782-20207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI61125OtherDEAN HEALTH INSURANCE
WI741501902Medicare PIN
WI61125OtherDEAN HEALTH INSURANCE