Mercedat, Jerry U.

Mercedat, Jerry U. is an individual health care provider with primary practice located at 631 Professional Dr Ste 170 , Lawrenceville GA 30046-3392. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mercedat, Jerry U. can be contacted via phone (678) 312-2663.

Contact Information

Primary practice address
631 Professional Dr Ste 170 Lawrenceville GA 30046-3392
Phone: (678) 312-2663
Fax: (770) 962-8587
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 004283 Georgia

Profile Details

NPI number 1750320685
LBN Legal business name Mercedat, Jerry U.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Sep 11th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750320685 NPPES
Georgia MEDICAID 860522900F

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