Healthcare Provider Details
I. General information
NPI: 1083025316
Provider Name (Legal Business Name): DAVID W. MAYS JR. P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/08/2014
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11109 PARKVIEW PLAZA DR
FORT WAYNE IN
46845-1701
US
IV. Provider business mailing address
608 UNION CHAPEL RD
FORT WAYNE IN
46845-9357
US
V. Phone/Fax
- Phone: 260-266-1700
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 10001687A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: