MEDICARE: MERCYMED OF COLUMBUS INC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1316729734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCYMED OF COLUMBUS INC

Provider Business Mailing Address
First Line	:	3679 STEAM MILL RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31906-4360
Country	:	US
Telephone Number	:	706-507-9209
Fax Number	:	706-507-9249

Provider Business Practice Location Address
First Line	:	3679 STEAM MILL RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31906-4360
Country	:	US
Telephone Number	:	706-507-9209
Fax Number	:	706-507-9249

Authorized Official
Title or Position	:	CHIEF OPERATIONS OFFICER
Name	:	MR. TONY NGUYEN
Credential	:
Telephone Number	:	706-507-9209

Provider Enumeration Date	:	10/19/2023
Last Update Date	:	10/19/2023

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Directions to “MERCYMED OF COLUMBUS INC ” Practice Location

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