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Individual
LORI E. MADDOX
Active
Individual
LORI E. MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
15-01067
KS
363A00000X
Physician Assistant
Primary
C06664
MD
363A00000X
Physician Assistant
PA00097
MS
Other
Enumeration date
02/08/2006
Last updated
06/10/2022
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