Individual
MICHAEL MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 W ESPLANADE AVE, SUITE 210, KENNER, LA 70065-2489
(504) 464-8588
(504) 464-8586
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2483
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD.205949
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02158023
—
MS
05
—
2339109
—
LA
Enumeration date
06/26/2008
Last updated
11/17/2015
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