Provider Demographics
NPI:1730399304
Name:MERRILL, ANTHONY PATTERSON (DO)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:PATTERSON
Last Name:MERRILL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:ANTHONY
Other - Middle Name:PATTERSON
Other - Last Name:MERRILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:20100 N 51ST AVE STE F620
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5084
Mailing Address - Country:US
Mailing Address - Phone:623-376-6328
Mailing Address - Fax:623-566-6454
Practice Address - Street 1:20100 N 51ST AVE STE F620
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5084
Practice Address - Country:US
Practice Address - Phone:623-376-6328
Practice Address - Fax:623-566-6454
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR938207R00000X
AZ005947207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine