# CHARLES MAULDIN, MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962707075
- **Authorized official:** DR. CHARLES C MAULDIN JR. M.D. (OWNER)
- **Authorized official phone:** (417) 848-2161

## Contact information

- **Practice address:** 3003 E CHESTNUT EXPY STE 109, SPRINGFIELD, MO 65802-2527
- **Practice address phone:** (417) 865-0011
- **Practice address fax:** (417) 865-0040
- **Mailing address:** PO BOX 14513, SPRINGFIELD, MO 65814-0513
- **Mailing address phone:** (417) 848-2161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | R6J28 | MO | Yes |

## Other

- **Enumeration date:** 01/20/2011
- **Last updated:** 01/20/2011