Individual
JUAN FULGENCIO MERCADO GUZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7050 AIR DEPOT BLVD, TINKER AFB, OK 73145-8716
(405) 582-6644
Mailing address
7050 AIR DEPOT BLVD, TINKER AFB, OK 73145-8716
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
05/26/2016
Last updated
08/01/2025
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