Doctor Name: | DARREN MICHAEL MAYER |
NPI Number: | 1033159611 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 04774 |
Business Practice Address: | 11740 Columbia St Blakely, GA - 398232574 |
Business Phone Number: | 2297244235 |
Business Fax Number: | 2297232930 |
Mailing Address: | 920 Us Highway 84 W, THOMASVILLE |
State: | GA |
Postal Code: | 317920510 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/08/2006 |
NPI Last Update Date: | 05/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 04774 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |