MEDICARE: DR. OWITA R MAYS MD

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	207R00000X	Internal Medicine Physician	35816	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3618742	OTHER		CIGNA
2	4097002	OTHER	TN	BLUE CROSS BLUE SHIELD
3	2260408	OTHER		UNITED HEALTHCARE
4	7856361	OTHER		AETNA

General Provider Information

NPI Number	:	1215930094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OWITA R MAYS MD

Provider Business Mailing Address
First Line	:	351 S ROWLETT ST
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-2554
Country	:	US
Telephone Number	:	901-568-2606
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 W. POPLAR AVENUE
Second Line	:	SUITE 202
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-2544
Country	:	US
Telephone Number	:	901-861-9090
Fax Number	:	901-861-9099

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	03/25/2024

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