Organization
CHARLES MAULDIN, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES C MAULDIN JR. M.D. (OWNER)
(417) 848-2161
Entity
Organization
Contact information
Practice address
3003 E CHESTNUT EXPY STE 109, SPRINGFIELD, MO 65802-2527
(417) 865-0011
(417) 865-0040
Mailing address
PO BOX 14513, SPRINGFIELD, MO 65814-0513
(417) 848-2161
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
R6J28
MO
Other
Enumeration date
01/20/2011
Last updated
01/20/2011
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