Individual
MRS. LIBBIA A MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
617 23RD ST STE 415, ASHLAND, KY 41101-2882
(606) 325-6888
(606) 326-9368
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 325-6888
(606) 326-9368
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA589
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100006060
—
KY
Enumeration date
07/13/2006
Last updated
10/12/2021
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