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Individual
KURT A MADDOCK
Active
Individual
KURT A MADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
036.144660
IL
208600000X
Surgery Physician
01038293A
IN
208600000X
Surgery Physician
036144660
IL
Other
Enumeration date
02/09/2006
Last updated
08/03/2021
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