Provider Demographics
NPI:1881049328
Name:MAYES, STEPHEN D (HAD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:MAYES
Suffix:
Gender:M
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 COUNTY ROAD 220 STE 2
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-4374
Mailing Address - Country:US
Mailing Address - Phone:904-572-3079
Mailing Address - Fax:904-531-3280
Practice Address - Street 1:3770 DUE WEST RD NW STE 300
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-1016
Practice Address - Country:US
Practice Address - Phone:678-581-0506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS000696237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist