Provider Demographics
NPI:1215930094
Name:MAYS, OWITA R (MD)
Entity type:Individual
Prefix:DR
First Name:OWITA
Middle Name:R
Last Name:MAYS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:351 S ROWLETT ST
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-2554
Mailing Address - Country:US
Mailing Address - Phone:901-568-2606
Mailing Address - Fax:
Practice Address - Street 1:1500 W. POPLAR AVENUE
Practice Address - Street 2:SUITE 202
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-2544
Practice Address - Country:US
Practice Address - Phone:901-861-9090
Practice Address - Fax:901-861-9099
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35816207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3618742OtherCIGNA
TN4097002OtherBLUE CROSS BLUE SHIELD
2260408OtherUNITED HEALTHCARE
7856361OtherAETNA
TN4097002OtherBLUE CROSS BLUE SHIELD
TN3874256Medicare ID - Type Unspecified
2260408OtherUNITED HEALTHCARE