MEDICARE: ALEXANDER J. MERCER, M.D., LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1871843839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXANDER J. MERCER, M.D., LLC

Provider Business Mailing Address
First Line	:	418 CREEKSTONE RIDGE
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-3740
Country	:	US
Telephone Number	:	678-494-8988
Fax Number	:	678-494-1300

Provider Business Practice Location Address
First Line	:	418 CREEKSTONE RIDGE
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-3740
Country	:	US
Telephone Number	:	678-494-8988
Fax Number	:	678-494-1300

Authorized Official
Title or Position	:	SOLE OWNER
Name	:	MR. ALEXANDER J. MERCER
Credential	:	MD
Telephone Number	:	678-494-8988

Provider Enumeration Date	:	09/17/2012
Last Update Date	:	09/17/2012

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