Provider Demographics
NPI:1114132818
Name:MERRICK, MARNIN A (MD)
Entity Type:Individual
Prefix:
First Name:MARNIN
Middle Name:A
Last Name:MERRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5107 CITRUS BLVD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70123-7148
Mailing Address - Country:US
Mailing Address - Phone:606-213-0275
Mailing Address - Fax:
Practice Address - Street 1:1430 TULANE AVE
Practice Address - Street 2:SL-68
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:504-988-6060
Practice Address - Fax:504-988-6077
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY411602085R0001X
LAMD.2028442085R0001X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology