Individual
GARY D MAYFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2200 E PARRISH AVE, C-104, OWENSBORO, KY 42303-1449
(270) 852-1632
(270) 852-1633
Mailing address
2200 E PARRISH AVE, C-104, OWENSBORO, KY 42303-1449
(270) 852-1632
(270) 852-1633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
334
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95003349
—
KY
Enumeration date
07/19/2005
Last updated
05/01/2013
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