Provider Demographics
NPI:1396841698
Name:ANDERSON, MERLIN G (MD)
Entity Type:Individual
Prefix:DR
First Name:MERLIN
Middle Name:G
Last Name:ANDERSON
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 1:3509 CLIFF VIEW LOOP
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76087-2223
Mailing Address - Country:US
Mailing Address - Phone:817-613-0070
Mailing Address - Fax:
Practice Address - Street 1:3509 CLIFF VIEW LOOP
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76087-2223
Practice Address - Country:US
Practice Address - Phone:817-613-0070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG11262207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery