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General NPI Number Information
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NPI Number | 1952465197
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Entity Type | Individual
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Provider Name | ROBERT C MAYFIELD PH. D
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Gender | Male
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 06/03/2015
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Provider Practice Location Address
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Address Line | 125 CHAPARREL BLVD NW
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City | DEMING
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State | NM
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Zip | 88030-8629
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Country | US
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Telephone | 575-546-4800
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Fax | 575-546-0685
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Provider Business Mailing Address
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Address Line | PO BOX 370
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City | HATCH
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State | NM
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Zip | 87937-0370
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Country | US
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Telephone | 575-267-3280
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Fax | 575-267-1747
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 0943
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | NM 0010C
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0943
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | 0008
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License Number State | NM
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