Individual
JUSTIN MERCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2500 BELLE CHASSE HWY, TERRYTOWN, LA 70056-7127
(504) 392-3131
Mailing address
15 GLACIER CT, NEW ORLEANS, LA 70131-8605
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.200823
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02955357
—
MS
05
—
2400363
—
LA
Enumeration date
07/12/2015
Last updated
11/09/2015
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