Individual
DR. COREY J. MAYFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6451 BRENTWOOD STAIR RD., #200, FORT WORTH, TX 76112
(817) 496-9700
(817) 507-1763
Mailing address
6451 BRENTWOOD STAIR RD., #200, FORT WORTH, TX 76112
(817) 496-9700
(817) 507-1763
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M8819
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP1-0026726
INSTITUTIONAL PERMIT
—
Enumeration date
05/31/2007
Last updated
03/26/2013
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