# MERCYLAND PSYCHIATRY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mercyland Psychiatry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194228114
- **Authorized official:** DR. ADEBOWALE MOFIKOYA MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (802) 399-9114

## Contact information

- **Practice address:** 530 W MAIN ST, SUN PRAIRIE, WI 53590-3219
- **Practice address phone:** (802) 399-9114
- **Practice address fax:** (608) 318-2789
- **Mailing address:** 530 W MAIN ST, SUN PRAIRIE, WI 53590-3219
- **Mailing address phone:** (802) 399-9114
- **Mailing address fax:** (608) 318-2789

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 60574-20 | WI | Yes |

## Other

- **Enumeration date:** 03/15/2018
- **Last updated:** 05/07/2018