Provider Demographics
NPI:1497572960
Name:MAYNARD, CURTIS
Entity type:Individual
Prefix:
First Name:CURTIS
Middle Name:
Last Name:MAYNARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 MONTLIMAR DR STE 929
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-1723
Mailing Address - Country:US
Mailing Address - Phone:251-752-0447
Mailing Address - Fax:
Practice Address - Street 1:1110 MONTLIMAR DR STE 929
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-1723
Practice Address - Country:US
Practice Address - Phone:251-752-0447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)