Provider Demographics
NPI:1619973138
Name:MERCER, PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:MERCER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1708
Mailing Address - Country:US
Mailing Address - Phone:270-780-0560
Mailing Address - Fax:270-780-0467
Practice Address - Street 1:2724 NASHVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-4000
Practice Address - Country:US
Practice Address - Phone:270-780-0560
Practice Address - Fax:270-780-0467
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY24067207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64240674Medicaid
KY030002978OtherRAILROAD MEDICARE
KY45651015Medicaid
KY1157174OtherPASSPORT
KY000000044737OtherANTHEM
KY0689102Medicare PIN
KY1537019Medicare PIN
KY45651015Medicaid
KYE61108Medicare UPIN
KY000000044737OtherANTHEM