Individual
DR. GREGORY J MAYFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2219 LINE AVE, SHREVEPORT, LA 71104-2128
(318) 828-1517
(318) 828-1685
Mailing address
2219 LINE AVE, SHREVEPORT, LA 71104-2128
(318) 828-1517
(318) 828-1685
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1067
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
721372556
FED TAX ID #
LA
Enumeration date
05/19/2006
Last updated
02/15/2025
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