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Organization

JAMES STEPHEN MADDOX

Active
Other names
Dermatology Associates
Organization subpart
No

Provider details

NPI number
Authorized official
CAROLYN STONE BARRETT (OFFICE MANAGER)
(334) 396-1555
Entity
Organization

Contact information

Practice address
286 MITYLENE PARK DR, MONTGOMERY, AL 36117
(334) 396-1555
(334) 396-9833
Mailing address
PO BOX 241627, MONTGOMERY, AL 36124-1627
(334) 396-1555
(334) 396-9833

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
00009695
AL
207N00000X
Dermatology Physician
Primary
10825
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
511-30216
BCBS
AL
05
528501290
AL
01
CM4358
RR MCR
AL
Enumeration date
12/28/2006
Last updated
12/12/2012
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