Individual
JEFFREY THOMAS MAUDLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1209 W TARGET RANGE RD, NOGALES, AZ 85621-2466
(520) 287-4747
(520) 285-3136
Mailing address
2202 N FORBES BLVD, TUCSON, AZ 85745-1412
(520) 287-4747
(520) 285-3136
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17138
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280123
—
AZ
Enumeration date
06/13/2006
Last updated
07/22/2011
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