Organization
MAYNARD E GARRETT MD APMC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAYNARD E GARRETT JR. MD (PRESIDENT)
(985) 847-1995
Entity
Organization
Contact information
Practice address
985 ROBERT BOULEVARD, SUITE 104, SLIDELL, LA 70458
(985) 847-1995
(985) 847-1992
Mailing address
985 ROBERT BOULEVARD, SUITE 104, SLIDELL, LA 70458
(985) 847-1995
(985) 847-1992
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
LA12053
LA
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
LA12053
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1139572
—
LA
Enumeration date
06/02/2008
Last updated
06/02/2008
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