1346748274 NPI number — JONATHAN DAVID MAYS PHYSICIAN ASSISTANT

Table of content: JONATHAN DAVID MAYS PHYSICIAN ASSISTANT (NPI 1346748274)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346748274 NPI number — JONATHAN DAVID MAYS PHYSICIAN ASSISTANT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAYS
Provider First Name:
JONATHAN
Provider Middle Name:
DAVID
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHYSICIAN ASSISTANT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346748274
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/25/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11527 SWEET BIRCH LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28278-6888
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
LANDSTUHL REGIONAL MEDICAL CENTER (LRMC)
Provider Second Line Business Practice Location Address:
BLDG 3758
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
66849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-497-3786
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/25/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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