Provider Demographics
NPI:1952340531
Name:MERKLE, DENNIS A (PA-C)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:A
Last Name:MERKLE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL DR STE 306
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9350
Mailing Address - Country:US
Mailing Address - Phone:570-522-4110
Mailing Address - Fax:570-768-3911
Practice Address - Street 1:7095 WESTBRANCH HWY STE 1000
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-6864
Practice Address - Country:US
Practice Address - Phone:570-523-3006
Practice Address - Fax:570-523-0404
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000612L363AM0700X
PAOA000196L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232809429004OtherTRICARE
PA50070396OtherKEYSTONE
PAP00451204OtherRAILROAD MEDICARE
PA50070396OtherCAPITAL BLUE CROSS
PA111334KV8Medicare PIN
PA232809429004OtherTRICARE