Healthcare Provider Details

I. General information

NPI: 1831345503
Provider Name (Legal Business Name): PAUL RAYMOND MAYO II O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US NMRTU SASEBO JAPAN
FPO NAGASAKI PREFECTURE
96350
JP

IV. Provider business mailing address

U.S. NAVAL HOSPITAL YOKOSUKA PSC 475 BOX 1
FPO AP
96350
US

V. Phone/Fax

Practice location:
  • Phone: 315-252-2541
  • Fax:
Mailing address:
  • Phone: 315-252-2541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1552
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: