Provider Demographics
NPI:1063690428
Name:MAYFIELD, PERLA A
Entity type:Individual
Prefix:
First Name:PERLA
Middle Name:A
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 SQUIB ANO RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-5558
Mailing Address - Country:US
Mailing Address - Phone:606-416-7742
Mailing Address - Fax:606-678-2004
Practice Address - Street 1:242 SQUIB ANO RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-5558
Practice Address - Country:US
Practice Address - Phone:606-416-7742
Practice Address - Fax:606-678-2004
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter