Organization
MICHAEL BRADLEY MAYFIELD MD PA
Active
Other names
Ozark General Surgery PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL BRADLEY MAYFIELD MD (PRESIDENT)
(870) 265-9364
Entity
Organization
Contact information
Practice address
2729 S HIGHWAY 65 82, LAKE VILLAGE, AR 71653-6136
(870) 265-9364
(870) 265-9366
Mailing address
2729 S HIGHWAY 65 82, LAKE VILLAGE, AR 71653-6136
(870) 265-9364
(870) 265-9366
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160587002
—
AR
Enumeration date
11/13/2006
Last updated
01/09/2009
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