Provider Demographics
NPI:1649367277
Name:MERCIER, DOUGLAS CHRISTOPHER (DC)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:CHRISTOPHER
Last Name:MERCIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-1706
Mailing Address - Country:US
Mailing Address - Phone:662-562-9021
Mailing Address - Fax:662-562-9021
Practice Address - Street 1:559 N ROBINSON ST
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-2118
Practice Address - Country:US
Practice Address - Phone:662-562-9021
Practice Address - Fax:662-562-9021
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS940111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0118014Medicaid
MS0118014Medicaid