Madock, Jacob David
Madock, Jacob David is an individual health care provider with primary practice located at 9093 Ridgefield Dr Ste 107 , Frederick MD 21701-6711. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Madock, Jacob David can be contacted via phone (301) 620-8566.Contact Information
Primary practice address
9093 Ridgefield Dr Ste 107
Frederick MD 21701-6711
Phone: (301) 620-8566
Fax: (301) 620-8568
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | S04154 | Maryland |
Profile Details
| NPI number | 1427767607 |
|---|---|
| LBN Legal business name | Madock, Jacob David |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 16th, 2022 |
| Last updated | Nov 16th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427767607 | NPPES |
| Maryland | MEDICAID | S04154 |
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