Dr. Mervin Dale Terrell
Geriatric Medicine
1220 W 42nd Ave
Pine Bluff
, Arkansas 71603-7109
Dr. Mervin Dale Terrell
Geriatric Medicine
1220 W 42nd Ave
Pine Bluff
, Arkansas 71603-7109
(870) 541-0014
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About
Features
Specialties
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Dr. Mervin Dale Terrell
- 1220 W 42nd Ave
- Pine Bluff, AR
- Zip : 71603-7109
- Fax : (870) 541-0014
- Phone : (870) 541-0013
Second Address
- Dr. Mervin Dale Terrell
- 1220 W 42nd Ave
- Pine Bluff, AR
- Zip : 71603-7109
- Fax : (870) 541-0014
- Phone : (870) 541-0013
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Is Dr. Mervin Dale Terrell a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0300X | Geriatric Medicine | E3820 | AR |
National Provider Identifier
| NPI | 1043202856 |
|---|---|
| Provider Name | Dr. Mervin Dale Terrell |
| First Address | Pine Bluff, AR 71603-7109 |
| Second Address | Pine Bluff, AR 71603-7109 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/08/2005 |
| Last Update Date | 13/03/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 150188001 | (05) | AR |
| 5M697 | BLUE CROSS BLUE SHIELD (01) | AR |
| A14076 | (02) | AR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.