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Individual

DR. STACEY WAYNE MAYEAUX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
519 E PRUDHOMME ST, OPELOUSAS, LA 70570-6499
(337) 678-3755
(337) 678-3757
Mailing address
PO BOX 8, OPELOUSAS, LA 70571-0008
(337) 678-3755
(337) 678-3757

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24994
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1423271
LA
Enumeration date
03/15/2006
Last updated
04/29/2016
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