Provider Demographics
NPI:1619191012
Name:MAULDIN, JAMES (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MAULDIN
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 1:10789 BRADFORD RD
Mailing Address - Street 2:STE 204
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-6406
Mailing Address - Country:US
Mailing Address - Phone:303-951-3765
Mailing Address - Fax:303-951-3764
Practice Address - Street 1:10789 BRADFORD RD
Practice Address - Street 2:STE 204
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-6406
Practice Address - Country:US
Practice Address - Phone:303-951-3765
Practice Address - Fax:303-951-3764
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO400432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO55222773Medicaid
COC473448Medicare PIN