Provider Demographics
NPI:1104993773
Name:MAYS, KIT SANFORD (MD)
Entity type:Individual
Prefix:
First Name:KIT
Middle Name:SANFORD
Last Name:MAYS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 205
Mailing Address - Street 2:PAIN CLINIC ASSOCIATES PC
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38101-0205
Mailing Address - Country:US
Mailing Address - Phone:901-255-9900
Mailing Address - Fax:901-842-6910
Practice Address - Street 1:55 HUMPHREYS CENTER DRIVE SUITE 200
Practice Address - Street 2:PAIN CLINIC ASSOCIATES PC
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2366
Practice Address - Country:US
Practice Address - Phone:901-747-0040
Practice Address - Fax:901-842-6910
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000008283207L00000X, 2081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2042040OtherUNITED HEALTHCARE
TN0017765OtherBLUE CROSS TN
TN3179049Medicaid
4057014OtherAETNA
2602558OtherCIGNA
4057014OtherAETNA
TN3179049Medicaid