Individual
ERIC MAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1431 DALZELL ST, SHREVEPORT, LA 71103-3709
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP09710
LA
Other
Enumeration date
01/26/2018
Last updated
01/26/2018
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