Organization
THE CORPORATION OF MERCER UNIVERSITY
Active
Other names
Mercer Health Systems, Mercer Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES DUFFEY (COO)
(478) 301-2362
Entity
Organization
Contact information
Practice address
250 MARTIN LUTHER KING JR BLVD, MACON, GA 31201-3490
(478) 301-4111
(478) 301-2272
Mailing address
250 MARTIN LUTHER KING JR BLVD, MACON, GA 31201-3490
(478) 301-2362
(478) 301-2272
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
104100000X
Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
2084F0202X
Forensic Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300018450U
—
GA
01
—
CC1498
RAILROAD MEDICARE
—
Enumeration date
11/08/2006
Last updated
01/26/2022
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