Provider Demographics
NPI:1225129398
Name:MERCER, COURTNEY ALLISON (BSRT RDMS)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:ALLISON
Last Name:MERCER
Suffix:
Gender:F
Credentials:BSRT RDMS
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:ALLISON
Other - Last Name:COLDWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5780 S PEORIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-7857
Mailing Address - Country:US
Mailing Address - Phone:918-858-5200
Mailing Address - Fax:918-582-4921
Practice Address - Street 1:1007 S PEORIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-4495
Practice Address - Country:US
Practice Address - Phone:918-587-1101
Practice Address - Fax:918-592-3024
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1008042471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography