Provider Demographics
NPI:1275160228
Name:MAYEAUX, JOSHUA R (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:R
Last Name:MAYEAUX
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2644 S SHERWOOD FST BLVD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816
Mailing Address - Country:US
Mailing Address - Phone:504-430-1989
Mailing Address - Fax:
Practice Address - Street 1:100 WOMANS WAY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817
Practice Address - Country:US
Practice Address - Phone:225-293-2523
Practice Address - Fax:225-293-1807
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA226318207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology