Mercer Medical Associates Psc | |
470 Linden Ave Suite 3 Harrodsburg KY 40330-1871 | |
(859) 734-4307 | |
(859) 734-4300 |
Full Name | Mercer Medical Associates Psc |
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Speciality | Family Medicine |
Location | 470 Linden Ave, Harrodsburg, Kentucky |
Authorized Official Name and Position | Thomas Cozatt Jackson (OWNER) |
Authorized Official Contact | 8597344307 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mercer Medical Associates Psc 470 Linden Ave Suite 3 Harrodsburg KY 40330-1871 Ph: (859) 734-4307 | Mercer Medical Associates Psc 470 Linden Ave Suite 3 Harrodsburg KY 40330-1871 Ph: (859) 734-4307 |
NPI Number | 1013106186 |
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Provider Enumeration Date | 10/15/2007 |
Last Update Date | 10/15/2007 |
Medicare PECOS PAC ID | 3072576289 |
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Medicare Enrollment ID | O20041109000577 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013106186 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 29222 (Kentucky) | Primary |
Provider Name | Thomas C Jackson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306818968 PECOS PAC ID: 5496718629 Enrollment ID: I20100916001262 |
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