Provider Demographics
NPI:1538366687
Name:MAYFIELD, KEVIN BILL (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:BILL
Last Name:MAYFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8230 BECKETT PARK DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069
Mailing Address - Country:US
Mailing Address - Phone:513-856-8100
Mailing Address - Fax:513-870-5242
Practice Address - Street 1:8230 BECKETT PARK DR
Practice Address - Street 2:SUITE B
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069
Practice Address - Country:US
Practice Address - Phone:513-856-8100
Practice Address - Fax:513-870-5242
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-059939208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0795626Medicaid
OHMA0672482Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
OH0795626Medicaid