Individual
NICHOLAS ANDREW MADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3850 S NATIONAL AVE, SPRINGFIELD, MO 65807-5287
(174) 269-6115
(417) 269-6679
Mailing address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807-5155
(417) 875-3462
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
2019017045
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200070335
—
MO
Enumeration date
04/04/2011
Last updated
08/16/2019
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