Organization
GASTROENTEROLOGY ASSOCIATES WEST PC
Active
Organization
GASTROENTEROLOGY ASSOCIATES WEST PC
Active
Other names
JACK L. MAULDIN, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK L. MAULDIN MD (PRESIDENT)
(205) 786-5527
Entity
Organization
Contact information
Practice address
833 PRINCETON AVE SW, SUITE 200D, BIRMINGHAM, AL 35211-1323
(205) 786-5527
(205) 786-5529
Mailing address
833 PRINCETON AVE SW, SUITE 200D, BIRMINGHAM, AL 35211-1323
(205) 786-5527
(205) 786-5529
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
6455
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000004027
—
AL
Enumeration date
05/28/2009
Last updated
05/28/2009
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