Provider Demographics
NPI:1598050031
Name:MINTON, MAURY P (MD)
Entity Type:Individual
Prefix:
First Name:MAURY
Middle Name:P
Last Name:MINTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 US HIGHWAY 43
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594-5263
Mailing Address - Country:US
Mailing Address - Phone:205-487-2066
Mailing Address - Fax:205-487-0383
Practice Address - Street 1:2775 US HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-5263
Practice Address - Country:US
Practice Address - Phone:205-487-2066
Practice Address - Fax:205-487-0383
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD32812207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine