JACK LEMUEL MAULDIN (NPI# 1770541096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770541096 |
| Entity Type | Individual |
| Full Name | JACK LEMUEL MAULDIN |
| Credential | MD |
| Practice Address |
833 Princeton Ave Sw Suite 200d Birmingham AL 35211-1323 |
| Practice Telephone | 2057865527 |
| Practice Fax Number | 2057865529 |
| Mailing Telephone | 2057865527 |
| Mailing Fax Number | 2057865529 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2009-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
6455 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 000004027 | 05 |
| Street Address |
833 PRINCETON AVE SW SUITE 200D |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35211-1323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639173271 | Clifton Thomas Pannell Lewis | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 833 Princeton Ave Sw, Suite 200a, Birmingham, AL 35211-1323 | 2005-06-10 |
| 1750901237 | Jacob Baldwin Switzer | Student in an Organized Health Care Education/Training Program | 833 Princeton Ave Sw, Birmingham, AL 35211-1323 | 2020-04-24 |
| 1396365862 | Heather Rose Russo | Student in an Organized Health Care Education/Training Program | 833 Princeton Ave Sw, Birmingham, AL 35211-1323 | 2020-04-24 |
| 1528688009 | William Chase Wiggins | Student in an Organized Health Care Education/Training Program | 833 Princeton Ave Sw, Birmingham, AL 35211-1323 | 2020-04-24 |
| 1699395178 | Whitney Jawan Smith | Student in an Organized Health Care Education/Training Program | 833 Princeton Ave Sw, Birmingham, AL 35211-1323 | 2020-04-24 |
| 1790305282 | Paul Yager | Student in an Organized Health Care Education/Training Program | 833 Princeton Ave Sw, Birmingham, AL 35211-1323 | 2020-04-24 |
| 1619597184 | Abigail Mcmurry Smith | Student in an Organized Health Care Education/Training Program | 833 Princeton Ave Sw, Birmingham, AL 35211-1323 | 2020-04-24 |
| 1023638871 | Long Ly | Student in an Organized Health Care Education/Training Program | 833 Princeton Ave Sw, Birmingham, AL 35211-1323 | 2020-04-22 |
| 1235759002 | James Clayton Parker IIi | Student in an Organized Health Care Education/Training Program | 833 Princeton Ave Sw, Birmingham, AL 35211-1323 | 2020-04-22 |
| 1285254052 | Bonnie Elizabeth Moore | Student in an Organized Health Care Education/Training Program | 833 Princeton Ave Sw, Birmingham, AL 35211-1323 | 2020-04-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982216123 | Tara Brown | Technician | 2007 Goldwire Trce, Birmington, AL 35211 | 2020-08-19 |
| 1477173318 | Jeffrey D. Cooney | Student in an Organized Health Care Education/Training Program | 833 Princeton Avenue Sw, Professional Office Bldg 3, Suite 200-e, Birmingham, AL 35211 | 2020-04-21 |
| 1982253852 | Josephine Cook | Technician | 1255 18th St Sw, Birmingham, AL 35211 | 2019-09-04 |
| 1154882322 | Stephen Jenkins | Registered Nurse | 701 Princeton Ave. Sw, Birmingham, AL 35211 | 2019-03-28 |
| 1780107052 | Negar Massah | Dentist | 2850 Venice Rd, Apt 1135, Birmingham, AL 35211 | 2017-07-19 |
| 1417075342 | Joseph Edward Mcjunkin | Pharmacist | 1308-tuscaloosa Ave.sw, Birmingham, AL 35211 | 2007-03-27 |
| 1669500880 | Prakash Chand Kansal | Internal Medicine | 801 Princeton Avenue, Pob 1, Suite 332., Birmingham, AL 35211 | 2007-03-01 |
| 1588717284 | Laquinta Johnson | Occupational Therapist | 420 10th St Sw, Birmingham, AL 35211 | 2007-01-18 |
| 1174613160 | Praveen Jetty | Psychiatry & Neurology | 401 Tuscaloosa Ave. S.w., Suite 110, Birmingham, AL 35211 | 2006-10-13 |
| 1326134180 | Yahya M Sabri | Obstetrics & Gynecology | 801 Princton Ave, Prof Office Bldg I Suite 332, Birmingham, AL 35211 | 2006-10-05 |
| Find all providers in zip 35211 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730579707 | Jerome Gaeton Ippolito | Internal Medicine | 4412 Fredricksburg Drive, Birmingham, AL 35213 | 2015-01-29 |
| 1588913867 | Muhammad Ali Khan | Internal Medicine | 1720 2nd Ave S # Bdb380, Birmingham, AL 35294 | 2012-09-03 |
| 1851646889 | Lewis Wayne Pressgrove Sr. | Internal Medicine | 2547 Ashford Pl, Birmingham, AL 35243-2244 | 2012-07-16 |
| 1871765552 | Shajan Peter | Internal Medicine | Bdb 363 1720 2nd Ave S, Birmingham, AL 35294 | 2008-04-02 |
| 1629154117 | Allison Duke Bridges | Internal Medicine | 703 19th St S, Zrb 633, Birmingham, AL 35294-0001 | 2006-10-27 |
| 1457433088 | Owen Russell Mclean | Internal Medicine | 1 Independence Plaza Suite 900, Birmingham, AL 35209-2643 | 2006-10-20 |
| 1598772865 | George Ralph Mcwhorter | Internal Medicine | 401 Tuscaloosa Ave Sw, Suite 220, Birmingham, AL 35211-1416 | 2006-08-01 |
| 1578516076 | Ralph Thomas Lyerly Jr. | Internal Medicine | 1532 Carraway Blvd, Suite 220, Birmingham, AL 35234-1955 | 2006-05-18 |
| 1366406514 | Birmingham Gastroenterology Associates PC | Internal Medicine | 1 Independence Plaza, Suite 900, Birmingham, AL 35209 | 2006-04-14 |
| 1780660142 | Kenneth M Sigman | Internal Medicine | 3570 Grandview Pkwy Ste 100, Birmingham, AL 35243-2065 | 2005-12-19 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35211 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.