Basic Information
| Provider Information | |||||||||
| NPI: | 1881853158 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAYARAO | ||||||||
| FirstName: | MAYUR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., M.SC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1411 E PRIMROSE ST STE C | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658044377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178821207 | ||||||||
| FaxNumber: | 4178817268 | ||||||||
| Practice Location | |||||||||
| Address1: | 3801 S NATIONAL AVE STE 700 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 65807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4178853888 | ||||||||
| FaxNumber: | 4175205959 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2008 | ||||||||
| LastUpdateDate: | 07/02/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | MT207746 | PA | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | MD15736 | RI | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 2018010679 | MO | Y | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | ME132344 | FL | N | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.