Provider Demographics
NPI:1598169245
Name:MAYFIELD, CODY ALEKSANDER
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:ALEKSANDER
Last Name:MAYFIELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 HARMON AVE
Mailing Address - Street 2:
Mailing Address - City:FT STEWART
Mailing Address - State:GA
Mailing Address - Zip Code:31314
Mailing Address - Country:US
Mailing Address - Phone:912-435-5254
Mailing Address - Fax:912-435-6325
Practice Address - Street 1:1601 HARMON AVE
Practice Address - Street 2:
Practice Address - City:FT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314
Practice Address - Country:US
Practice Address - Phone:912-435-5254
Practice Address - Fax:912-435-6325
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant