# KURT A MADDOCK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1740253707
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | 036.144660 | IL | Yes |
| 208600000X | Surgery Physician | 01038293A | IN | — |
| 208600000X | Surgery Physician | 036144660 | IL | — |

## Other

- **Enumeration date:** 02/09/2006
- **Last updated:** 08/03/2021