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General NPI Number Information
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NPI Number | 1538780226
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Entity Type | Individual
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Provider Name | CHRISTOPHER LANCE MAYFIELD MD
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Gender | Male
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Dates
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Enumeration Date | 05/04/2020
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 1993 HARRISON ST
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City | BATESVILLE
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State | AR
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Zip | 72501-7309
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Country | US
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Telephone | 870-793-2540
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Fax |
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Provider Business Mailing Address
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Address Line | 701 W 5TH ST
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City | ODESSA
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State | TX
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Zip | 79763-4206
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | U3293
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License Number State | TX
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