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NPI Code Detail

MEDICARE: DR. GREGORY J MAYFIELD DC

MEDICARE:  DR. GREGORY J MAYFIELD  DC
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
1111N00000XChiropractor1067LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1721372556OTHERLAFED TAX ID #

General Provider Information

NPI Number : 1972556793
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY J MAYFIELD DC
Provider Business Mailing Address
First Line : 2219 LINE AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71104-2128
Country : US
Telephone Number : 318-828-1517
Fax Number : 318-828-1685
Provider Business Practice Location Address
First Line : 2219 LINE AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71104-2128
Country : US
Telephone Number : 318-828-1517
Fax Number : 318-828-1685
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 02/15/2025

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Directions to “ DR. GREGORY J MAYFIELD DC” Practice Location

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