Individual
HOLT BENJAMIN MADDUX JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1325 WOLF PARK DR, SUITE 102, GERMANTOWN, TN 38138-1742
(901) 252-3400
(901) 682-0047
Mailing address
1325 WOLF PARK DR, SUITE 103, GERMANTOWN, TN 38138-1742
(901) 252-3411
(901) 384-6422
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
11107
TN
208800000X
Urology Physician
16103
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0063189
BLUE CROSS
TN
01
—
02110025300
QUAL CHOICE
—
01
—
115806
HEALTH LINK
—
01
—
12940170
PHCS
—
01
—
211159
SOUTHERN HEALTH SERVICES
—
01
—
2596090
CIGNA
—
05
—
3007327
—
TN
01
—
4563452
AETNA
—
01
—
731661
FIRST HEALTH
—
01
—
85552
BLUE CROSS AR
—
Enumeration date
04/28/2006
Last updated
07/08/2007
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