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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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