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Contact Information

CLINTON F MERRILL JR, MD
15 SHRINE CLUB RD
LANDER, WY82520-8501
 Phone: 307-332-0324
 Fax: 307-332-0382
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for CLINTON F MERRILL JR · (Male)

NPI # 1992707285
Status Active
Credentials MD
Entity Individual
Enumeration date 06/01/2005
Last updated 03/09/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • WY License # 3277A
  • CO Medicaid 63235552
  • NE Medicaid 10025668100
  • WY Medicaid 141495000
  • WY Other 311538 BCBS
  • WY Other W27189 MEDICARE PTAN (WY)
  • WY Other 3277A WYOMING MEDICAL LICENSE
Hospital affiliation(s)
  • NORTH BIG HORN HOSPITAL DISTRICT - (Critical Access)
    1115 LANE 12
    LOVELL, WY 82431
  • RIVERTON MEMORIAL HOSPITAL - (Acute Care)
    2100 W SUNSET DR
    RIVERTON, WY 82501
  • WEST PARK HOSPITAL DISTRICT - (Critical Access)
    707 SHERIDAN AVENUE
    CODY, WY 82414
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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