Provider Demographics
NPI:1386690378
Name:HOMER CURTISS MERRICK III MD DBA H CURTISS MERRICK MD
Entity Type:Organization
Organization Name:HOMER CURTISS MERRICK III MD DBA H CURTISS MERRICK MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOMER
Authorized Official - Middle Name:CURTISS
Authorized Official - Last Name:MERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-222-5790
Mailing Address - Street 1:PO BOX 914
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-0914
Mailing Address - Country:US
Mailing Address - Phone:252-222-5790
Mailing Address - Fax:252-222-5787
Practice Address - Street 1:3715 GUARDIAN AVE
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4323
Practice Address - Country:US
Practice Address - Phone:252-222-5790
Practice Address - Fax:252-222-5787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCDG6706OtherRAILROAD MEDICARE
NCDG6706OtherRAILROAD MEDICARE