Maynard Ernest Garrett Jr., M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

12053 Issued in LA

Practice address

985 Robert Blvd Ste 104
Slidell, LA 70458-2063

Phone

(985) 847-1995

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1275552986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 RUE JONATHAN",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615440",
            "telephone_number": "504-914-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 ROBERT BLVD STE 104",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582063",
            "telephone_number": "985-847-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "MAYNARD",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "12053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1139572",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC. NUMBER",
            "identifier": "12053",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1275552986",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keesha R Garcia, LPN
• Rachel Gardette, NP
• Abhishek Garg, M.D.
• William Vainard Garibaldi IV
• Maureen Garnica
• Teresa Elizabeth Garrison, M.D.
• Stephanie Lynn Gates, RPH
• Damaris Gautier, MD
• Duane Thomas Gayden Sr.
• Geaux 2 Pediatrics LLC

• Specialist in Slidell, LA
• Providers in Slidell, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.