Provider Demographics
NPI:1689419269
Name:MIKLER, MERCEDIES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MERCEDIES
Middle Name:
Last Name:MIKLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9080 RANDALL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-9050
Mailing Address - Country:US
Mailing Address - Phone:219-743-7289
Mailing Address - Fax:
Practice Address - Street 1:805 JOLIET ST
Practice Address - Street 2:
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-1920
Practice Address - Country:US
Practice Address - Phone:219-864-4314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26030758A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist