Provider Demographics
NPI:1376537043
Name:MAYO, JOSEPH FRANCIS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FRANCIS
Last Name:MAYO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 801143
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1143
Mailing Address - Country:US
Mailing Address - Phone:573-331-3000
Mailing Address - Fax:573-331-5073
Practice Address - Street 1:3250 GORDONVILLE RD STE 358
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-5095
Practice Address - Country:US
Practice Address - Phone:573-331-3155
Practice Address - Fax:573-331-5096
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20160098212086S0129X, 208600000X
KY28667208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000050284OtherANTHEM BC/BS
KY64286677Medicaid
KY1533501Medicare PIN
KY64286677Medicaid