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Individual
MARY H MADDOX
Active
Individual
MARY H MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD.27820
AL
208000000X
Pediatrics Physician
Primary
MD.27820
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102380
—
AL
05
—
102407
—
AL
01
—
1053529289
TRICARE SOUTH
AL
01
—
515-90435
BCBS
AL
01
—
515-91033
BCBS
AL
Enumeration date
05/20/2007
Last updated
01/24/2011
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