Provider Demographics
NPI:1437205242
Name:MAYEUX, JR., LOVELL JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:LOVELL
Middle Name:JOHN
Last Name:MAYEUX, JR.
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1444 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARKSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71351-3217
Mailing Address - Country:US
Mailing Address - Phone:318-253-7077
Mailing Address - Fax:318-253-0661
Practice Address - Street 1:1444 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-3217
Practice Address - Country:US
Practice Address - Phone:318-253-7077
Practice Address - Fax:318-253-0661
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA014179207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine