Provider Demographics
NPI:1760467708
Name:MAYS, WARREN LANCE (MD)
Entity Type:Individual
Prefix:MR
First Name:WARREN
Middle Name:LANCE
Last Name:MAYS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4493 SAN FELIPE RD
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86429-7719
Mailing Address - Country:US
Mailing Address - Phone:775-823-1999
Mailing Address - Fax:775-823-1966
Practice Address - Street 1:77 PRINGLE WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1474
Practice Address - Country:US
Practice Address - Phone:775-823-1999
Practice Address - Fax:775-823-1966
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10670174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100506808Medicaid
NVH76826Medicare UPIN
NV100506808Medicaid