Mauldin, Charles C

Mauldin, Charles C is an sole proprietor health care provider with primary practice located at 1308 N Glenstone Ave , Springfield MO 65802-2130. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Mauldin, Charles C can be contacted via phone (417) 864-4100.

Contact Information

Primary practice address
1308 N Glenstone Ave Springfield MO 65802-2130
Phone: (417) 864-4100
Fax: (417) 863-8697
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X MDR6J28 Missouri

Profile Details

NPI number 1194718270
LBN Legal business name Mauldin, Charles C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 24th, 2005
Last updated Sep 27th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194718270 NPPES
Missouri MEDICAID 202697900
Missouri Other 43151887165802A005
Missouri Other ACS#140740000
Missouri Other 2079425
Missouri Other 19288
Missouri Other 26D1025378
Missouri Other 9378408

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