Provider Demographics
NPI:1871702464
Name:MERSKI, DENNIS WILLIAM (DO)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:WILLIAM
Last Name:MERSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 20TH AVE N STE 403
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5180
Mailing Address - Country:US
Mailing Address - Phone:615-284-4088
Mailing Address - Fax:615-284-7501
Practice Address - Street 1:1589 SPARTA ST STE 104
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-1392
Practice Address - Country:US
Practice Address - Phone:931-473-4714
Practice Address - Fax:931-815-5060
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2209207VX0000X
OH34.011034207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ047309Medicaid
OH0095803Medicaid
WV3810026907Medicaid
TN103I169457Medicare PIN