Olin Mauldin M.D., LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME54094 Issued in FL

Legal business name

OLIN MAULDIN M.D., LLC

Practice address

4217 Baymeadows Rd
Suite 3
Jacksonville, FL 32217-4676

Phone

(904) 332-7431

Fax

(904) 332-7408

NPI assigned

Sep 16, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wendy C Lu

Title

Credentialing Coordinator

Phone

(904) 332-7431

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1104227628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4217 BAYMEADOWS RD",
            "address_2": "SUITE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174676",
            "telephone_number": "904-332-7431",
            "fax_number": "904-332-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4217 BAYMEADOWS RD",
            "address_2": "SUITE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174676",
            "telephone_number": "904-332-7431",
            "fax_number": "904-332-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIN MAULDIN M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "LU",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "904-332-7431"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME54094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikayla Marie Oldham, MA
• Jennifer A Oles-Dugre, M.D.
• Olga Nick Assistant Care
• Nicholas A Olgee, PA-C
• Keeyon Olia, DO
• Brittny Ann Olinger, PT, DPT
• David Richard Olinzock, D.D.S.
• Anny Oliva Perez, DMD
• Arcadio J Oliva, MD
• Vivian Esther Olivares

• Psychiatry Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.