Provider Demographics
NPI:1689646226
Name:MERTZ, JOHN D (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:MERTZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1101 S HORSEBARN RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8237
Mailing Address - Country:US
Mailing Address - Phone:479-271-9607
Mailing Address - Fax:479-271-2133
Practice Address - Street 1:1101 S HORSEBARN RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8237
Practice Address - Country:US
Practice Address - Phone:479-271-9607
Practice Address - Fax:479-271-2133
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARR-2992207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARC19327Medicare UPIN
AR53618Medicare PIN