# THE CORPORATION OF MERCER UNIVERSITY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Mercer Health Systems, Mercer Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174693162
- **Authorized official:** CHARLES DUFFEY (COO)
- **Authorized official phone:** (478) 301-2362

## Contact information

- **Practice address:** 250 MARTIN LUTHER KING JR BLVD, MACON, GA 31201-3490
- **Practice address phone:** (478) 301-4111
- **Practice address fax:** (478) 301-2272
- **Mailing address:** 250 MARTIN LUTHER KING JR BLVD, MACON, GA 31201-3490
- **Mailing address phone:** (478) 301-2362
- **Mailing address fax:** (478) 301-2272

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | NULL | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | — |
| 207RI0200X | Infectious Disease Physician | — | NULL | — |
| 207RI0200X | Infectious Disease Physician | — | — | — |
| 207RN0300X | Nephrology Physician | — | NULL | — |
| 207RN0300X | Nephrology Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 2084F0202X | Forensic Psychiatry Physician | — | NULL | — |
| 2084F0202X | Forensic Psychiatry Physician | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | — |
| 2084P0805X | Geriatric Psychiatry Physician | — | NULL | — |
| 2084P0805X | Geriatric Psychiatry Physician | — | — | — |
| 2084P2900X | Pain Medicine (Psychiatry & Neurology) Physician | — | NULL | — |
| 2084P2900X | Pain Medicine (Psychiatry & Neurology) Physician | — | — | — |

## Other

- **Enumeration date:** 11/08/2006
- **Last updated:** 01/26/2022