Maddox, Jeremiah J

Maddox, Jeremiah J is an individual health care provider with primary practice located at 1500 Ross Clark Cir , Dothan AL 36301-4754. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Maddox, Jeremiah J can be contacted via phone (334) 793-2663.

Contact Information

Primary practice address
1500 Ross Clark Cir Dothan AL 36301-4754
Phone: (334) 793-2663
Fax: (334) 836-2248
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 27935 Alabama

Profile Details

NPI number 1245449800
LBN Legal business name Maddox, Jeremiah J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 21st, 2007
Last updated Nov 20th, 2014 - about 12 years ago

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 1245449800 NPPES
Georgia MEDICAID 003112729A
Georgia Other 1245449800
Georgia MEDICAID 130085
Georgia MEDICAID 003112729B
Georgia Other 511-17847
Georgia MEDICAID 130087
Georgia Other 511-18371

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