| Doctor Name: | DR. JERRY ALAN MAYER |
| NPI Number: | 1235146101 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DMD |
| License Number: | 5949 |
| Business Practice Address: | 2301 South 7th Street Suite 1 Ironton, OH - 45638 |
| Business Phone Number: | 7405324613 |
| Business Fax Number: | 7405328099 |
| Mailing Address: | 2301 South 7th Street, Suite 1 IRONTON |
| State: | OH |
| Postal Code: | 45638 |
| Phone Number: | 7405324613 |
| Fax Number: | 7405328099 |
| NPI Enumeration Date: | 08/02/2006 |
| NPI Last Update Date: | 01/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | 5949 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |