Provider Demographics
NPI:1821153511
Name:MERCER, ALEXANDER JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:JOHN
Last Name:MERCER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 CREEKSTONE RDG
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-3740
Mailing Address - Country:US
Mailing Address - Phone:678-494-8988
Mailing Address - Fax:678-494-1300
Practice Address - Street 1:418 CREEKSTONE RDG
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-3740
Practice Address - Country:US
Practice Address - Phone:678-494-8988
Practice Address - Fax:678-494-1300
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0260062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA26BDDBFMedicare ID - Type Unspecified
GAA45122Medicare UPIN