Individual
ROBERT K MEHRLE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
(601) 960-4586
Mailing address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
(601) 960-4586
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
17298
MS
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
17298
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01227851
—
MS
01
—
200000479
MEDICARE
MS
01
—
512G700003
UP MEDICARE
MS
01
—
52I200004
MEDICARE PTAN
MS
01
—
P00325234
RROAD MEDICARE
MS
01
—
P00645611
RR PTAN
MS
Enumeration date
06/04/2006
Last updated
02/11/2013
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