Provider Demographics
NPI:1316729734
Name:MERCYMED OF COLUMBUS INC
Entity type:Organization
Organization Name:MERCYMED OF COLUMBUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-507-9209
Mailing Address - Street 1:3679 STEAM MILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-4360
Mailing Address - Country:US
Mailing Address - Phone:706-507-9209
Mailing Address - Fax:706-507-9249
Practice Address - Street 1:3679 STEAM MILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-4360
Practice Address - Country:US
Practice Address - Phone:706-507-9209
Practice Address - Fax:706-507-9249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty