Organization
OLIN MAULDIN M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY C LU (CREDENTIALING COORDINATOR)
(904) 332-7431
Entity
Organization
Contact information
Practice address
4217 BAYMEADOWS RD, SUITE 3, JACKSONVILLE, FL 32217-4676
(904) 332-7431
(904) 332-7408
Mailing address
4217 BAYMEADOWS RD, SUITE 3, JACKSONVILLE, FL 32217-4676
(904) 332-7431
(904) 332-7408
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME54094
FL
Other
Enumeration date
09/16/2014
Last updated
09/29/2014
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