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NPI Code Detail

MEDICARE: JASON R MERCER MD PA

MEDICARE: JASON R MERCER MD PA
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1891967089
Entity Type Code : Organization
Provider Name (Legal Business Name) : JASON R MERCER MD PA
Provider Business Mailing Address
First Line : 801 BEVILLE RD
Second Line : SUITE 201
City : SOUTH DAYTONA
State : FL
Zip : 32119-1860
Country : US
Telephone Number : 386-322-5200
Fax Number : 386-767-0062
Provider Business Practice Location Address
First Line : 801 BEVILLE RD
Second Line : SUITE 201
City : SOUTH DAYTONA
State : FL
Zip : 32119-1860
Country : US
Telephone Number : 386-322-5200
Fax Number : 386-767-0062
Authorized Official
Title or Position : PHYSICIAN/OWNER
Name : DR. JASON REED MERCER
Credential : M.D.
Telephone Number : 386-322-5200
Provider Enumeration Date : 03/27/2008
Last Update Date : 09/08/2010

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