Provider Demographics
NPI:1952411837
Name:MACLIN, JEANINE S (MD)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:S
Last Name:MACLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JEANINE
Other - Middle Name:LOUISE
Other - Last Name:SCARBER-MACLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1600 7TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1711
Mailing Address - Country:US
Mailing Address - Phone:205-638-9918
Mailing Address - Fax:205-975-2499
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-939-9918
Practice Address - Fax:205-939-9919
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL250742080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009958415Medicaid
AL009958415Medicaid
AL009957285Medicaid
AL009958415Medicaid
051522444Medicare ID - Type Unspecified