MEDICARE: TED JUDE MAYEUX D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	797	LA

General Provider Information

NPI Number	:	1194793521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TED JUDE MAYEUX D.C.

Provider Business Mailing Address
First Line	:	3213 MONTERREY DR
Second Line	:	SUITE A
City	:	BATON ROUGE
State	:	LA
Zip	:	70814-4065
Country	:	US
Telephone Number	:	225-925-5156
Fax Number	:	225-925-9647

Provider Business Practice Location Address
First Line	:	3213 MONTERREY DR
Second Line	:	SUITE A
City	:	BATON ROUGE
State	:	LA
Zip	:	70814-4065
Country	:	US
Telephone Number	:	225-925-5156
Fax Number	:	225-925-9647

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	07/08/2007

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