Individual
DR. JOHN COULTER MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 J CLYDE MORRIS BLVD, NEWPORT NEWS, VA 23601-1929
(757) 594-2160
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101032554
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006660819
—
VA
01
—
220017179
RAILROAD MEDICARE
—
05
—
890559X
—
NC
Enumeration date
10/10/2005
Last updated
03/12/2018
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