Individual
JAN RENEE MAYFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 278-2105
(865) 291-3228
Mailing address
49 HOSIERY MILL RD, STE 124, DALLAS, GA 30157-1688
(678) 986-2220
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
051355
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000967766B
—
GA
01
—
P00232715
RAILROAD MEDICARE
GA
Enumeration date
07/05/2006
Last updated
07/26/2021
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