Individual
DR. MAYNARD ERNEST GARRETT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
985 ROBERT BLVD STE 104, SLIDELL, LA 70458-2063
(985) 847-1995
Mailing address
217 RUE JONATHAN, SLIDELL, LA 70461-5440
(504) 914-5834
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12053
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1139572
—
LA
01
—
12053
STATE LIC. NUMBER
LA
01
—
1275552986
NPI
LA
Enumeration date
07/19/2006
Last updated
03/07/2023
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