Provider Demographics
NPI:1851360622
Name:MAYS, STAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:STAN
Middle Name:J
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 1:4242 GUS YOUNG AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-1733
Mailing Address - Country:US
Mailing Address - Phone:225-926-2348
Mailing Address - Fax:225-925-2520
Practice Address - Street 1:4242 GUS YOUNG AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-1733
Practice Address - Country:US
Practice Address - Phone:225-926-2348
Practice Address - Fax:225-925-2520
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL018505207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1362948Medicaid
LA54074Medicare PIN
LA1362948Medicaid