Individual
GAVIN CASEY MAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 COURSE DRIVE, SUITE M, CARRIERE, MS 39426-9037
(769) 242-3185
(769) 242-0099
Mailing address
PO BOX 1089, HAMMOND, LA 70404-1089
(985) 892-7070
(985) 892-7017
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
905668
MS
Other
Enumeration date
11/10/2022
Last updated
01/12/2023
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