Healthcare Provider Details

I. General information

NPI: 1619974284
Provider Name (Legal Business Name): WILLIAM K MAYFIELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 WILLOW ST STE 203
VINCENNES IN
47591-1029
US

IV. Provider business mailing address

1160 E SAINT CLAIR ST
VINCENNES IN
47591-4853
US

V. Phone/Fax

Practice location:
  • Phone: 812-882-1000
  • Fax: 812-885-1004
Mailing address:
  • Phone: 812-885-3325
  • Fax: 128-858-9878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01036429A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: