Provider Demographics
NPI:1184604076
Name:MERRY, WILLIAM H III (MD)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:H
Last Name:MERRY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1201 2ND AVE
Mailing Address - Street 2:PO BOX 347
Mailing Address - City:SHELDON
Mailing Address - State:IA
Mailing Address - Zip Code:51201-1960
Mailing Address - Country:US
Mailing Address - Phone:712-324-3298
Mailing Address - Fax:712-324-8233
Practice Address - Street 1:1201 2ND AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:SHELDON
Practice Address - State:IA
Practice Address - Zip Code:51201-1960
Practice Address - Country:US
Practice Address - Phone:712-324-3298
Practice Address - Fax:712-324-8233
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA32663208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0184416Medicaid
IAA05165Medicare UPIN
IA48093Medicare ID - Type Unspecified