Mayo, John Gerald

Mayo, John Gerald is an individual health care provider with primary practice located at 122 1St Ave , Fairbanks AK 99701-4871. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Mayo, John Gerald can be contacted via phone (907) 452-8251.

Contact Information

Primary practice address
122 1St Ave Fairbanks AK 99701-4871
Phone: (907) 452-8251
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1447801857
LBN Legal business name Mayo, John Gerald
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2019
Last updated Sep 26th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447801857 NPPES
Alaska MEDICAID 1021051

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