Individual
DR. LYMAN TERRY MADDOX JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12 QUINCY PL NE, WASHINGTON, DC 20002-2134
(202) 412-3725
Mailing address
1629 K ST NW STE 300, WASHINGTON, DC 20006-1631
(202) 412-3725
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
92-1101966
NA
DC
Enumeration date
11/28/2022
Last updated
10/10/2023
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