Provider Demographics
NPI:1386818763
Name:MERKLEY, LOUIS J JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:J
Last Name:MERKLEY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2736 RING RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-9151
Mailing Address - Country:US
Mailing Address - Phone:270-769-1138
Mailing Address - Fax:270-737-2373
Practice Address - Street 1:2736 RING RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-9151
Practice Address - Country:US
Practice Address - Phone:270-769-1138
Practice Address - Fax:270-737-2373
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY45051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice