Maddox, Bryan

Maddox, Bryan is an individual health care provider with primary practice located at 1373 E State Road 62 , Madison IN 47250-7328. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Maddox, Bryan can be contacted via phone (812) 801-0800.

Contact Information

Primary practice address
1373 E State Road 62 Madison IN 47250-7328
Phone: (812) 801-0800
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X CS0365835 Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71012403A Indiana

Profile Details

NPI number 1215687058
LBN Legal business name Maddox, Bryan
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2022
Last updated Jan 3rd, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215687058 NPPES
Kentucky MEDICAID 7100813710
Kentucky Other 412840155
Kentucky MEDICAID 300062802

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