MEDICARE: DR. STAN J. MAYS M.D.

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	207Q00000X	Family Medicine Physician	L018505	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851360622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STAN J. MAYS M.D.

Provider Business Mailing Address
First Line	:	4242 GUS YOUNG AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70802-1733
Country	:	US
Telephone Number	:	225-926-2348
Fax Number	:	225-925-2520

Provider Business Practice Location Address
First Line	:	4242 GUS YOUNG AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70802-1733
Country	:	US
Telephone Number	:	225-926-2348
Fax Number	:	225-925-2520

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

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	12/07/2010

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