Individual
JOSE L MADARA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
102 HOTEL ST, BOONEVILLE, MS 38829-3303
(662) 728-7711
(661) 728-7713
Mailing address
102 HOTEL ST, BOONEVILLE, MS 38829-3303
(662) 728-7711
(661) 728-7713
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
7928
MS
Other
Enumeration date
09/18/2007
Last updated
09/18/2007
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