# MERCY CLINIC OF JACKSON, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306047105
- **Authorized official:** SUSAN PRATT (CLINIC MANAGER)
- **Authorized official phone:** (606) 693-0343

## Contact information

- **Practice address:** 1550 HIGHWAY 15 S, SUITE 80, JACKSON, KY 41339-7247
- **Practice address phone:** (606) 693-0343
- **Practice address fax:** (606) 693-0322
- **Mailing address:** 1550 HIGHWAY 15 S, SUITE 80, JACKSON, KY 41339-7247
- **Mailing address phone:** (606) 693-0343
- **Mailing address fax:** (606) 693-0322

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 31497 | KY | Yes |

## Other

- **Enumeration date:** 05/30/2007
- **Last updated:** 10/04/2007