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Organization

MERCER PEDIATRICS PSC

Active
Other names
Haggin Primary Care Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAMELA G JOHNSON MD (PRESIDENT/CEO)
(859) 734-5123
Entity
Organization

Contact information

Practice address
466 LINDEN AVE, HARRODSBURG, KY 40330-1841
(859) 734-5123
(859) 734-0664
Mailing address
PO BOX 364, 466 LINDEN AVENUE, HARRODSBURG, KY 40330-0364
(859) 734-5123
(859) 734-0664

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25108
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
610510934
KY
05
65929507
KY
Enumeration date
06/13/2006
Last updated
03/07/2014
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