Provider Demographics
NPI:1831115047
Name:MERRITT, JAMES MILTON (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MILTON
Last Name:MERRITT
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 1:2710 RIFE MEDICAL LANE
Mailing Address - Street 2:HOSPITALIST
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758
Mailing Address - Country:US
Mailing Address - Phone:479-338-8000
Mailing Address - Fax:479-338-2906
Practice Address - Street 1:2710 RIFE MEDICAL LANE
Practice Address - Street 2:HOSPITALIST
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758
Practice Address - Country:US
Practice Address - Phone:479-338-8000
Practice Address - Fax:479-338-2906
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-4506208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR106379001Medicaid
53638Medicare ID - Type Unspecified
D84284Medicare UPIN