Provider Demographics
NPI:1053938001
Name:MERKLE, THOMAS (EMT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:MERKLE
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 BOWEN LN
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MI
Mailing Address - Zip Code:49082-8407
Mailing Address - Country:US
Mailing Address - Phone:517-610-9569
Mailing Address - Fax:
Practice Address - Street 1:1036 BOWEN LN
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MI
Practice Address - Zip Code:49082-8407
Practice Address - Country:US
Practice Address - Phone:517-610-9569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MITEMP-00267146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic