Healthcare Provider Details

I. General information

NPI: 1205988540
Provider Name (Legal Business Name): JOHN WHITNEY MERCER JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4424 E FLAMINGO AVE STE 200
NAMPA ID
83687-9300
US

IV. Provider business mailing address

715 S 3RD ST
MONTROSE CO
81401-4209
US

V. Phone/Fax

Practice location:
  • Phone: 208-302-1400
  • Fax: 208-302-1455
Mailing address:
  • Phone: 970-249-6737
  • Fax: 970-252-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberL023779
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberCDR.0000210
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number3971468
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: