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NPI Code Detail

MEDICARE: MERCER PEDIATRICS PSC

MEDICARE: MERCER PEDIATRICS PSC
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
1208000000XPediatrics Physician25108KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669415493
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCER PEDIATRICS PSC
Provider Business Mailing Address
First Line : PO BOX 364
Second Line : 466 LINDEN AVENUE
City : HARRODSBURG
State : KY
Zip : 40330-0364
Country : US
Telephone Number : 859-734-5123
Fax Number : 859-734-0664
Provider Business Practice Location Address
First Line : 466 LINDEN AVE
Second Line :
City : HARRODSBURG
State : KY
Zip : 40330-1841
Country : US
Telephone Number : 859-734-5123
Fax Number : 859-734-0664
Authorized Official
Title or Position : PRESIDENT/CEO
Name : DR. PAMELA G JOHNSON
Credential : MD
Telephone Number : 859-734-5123
Provider Enumeration Date : 06/13/2006
Last Update Date : 03/07/2014

Similar Medicare Providers

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Practice Location Address:
466 LINDEN AVE
HARRODSBURG, KY
40330-1841
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1609868033 — DR. STEVEN HALL M.D.
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466 LINDEN AVE
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1679523559 — NICK DEDMAN, MD AND ASSOCIATES, P.S.C.
Practice Location Address:
466 LINDEN AVE
HARRODSBURG, KY
40330-1841
Practice Phone: 859-734-5173
Practice Fax: 859-734-9925
1710921242 — DR. WILLIAM FREDERICK LOGGINS MD
Practice Location Address:
466 LINDEN AVE
HARRODSBURG, KY
40330-1841
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Practice Fax:
1174543722 — SANDRA GEILE MD
Practice Location Address:
466 LINDEN AVE
HARRODSBURG, KY
40330-1841
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1083928196 — LORRIE THOMPSON DNP
Practice Location Address:
466 LINDEN AVE
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40330-1841
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Practice Fax: 859-734-9925

Directions to “MERCER PEDIATRICS PSC ” Practice Location

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