Organization
MAYO MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAMIKA MAYO M.D. (MEDICAL DOCTOR)
(225) 381-2712
Entity
Organization
Contact information
Practice address
3401 NORTH BLVD, SUITE 360, BATON ROUGE, LA 70806-3743
(225) 381-2712
Mailing address
3401 NORTH BLVD, SUITE 410, BATON ROUGE, LA 70806-3743
(225) 381-2712
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
023611
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1576565
—
LA
Enumeration date
10/16/2007
Last updated
05/24/2011
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