Individual
EDWARD A MAYFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-5581
Mailing address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 675-5581
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN095629
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1463922
—
LA
05
—
193853201
—
TX
Enumeration date
09/20/2006
Last updated
09/08/2008
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