Individual
MR. JIMMY H MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN/MSN/FNP-BC
Contact information
Practice address
117 KITE ROAD, SWAINSBORO, GA 30401
(478) 289-1265
Mailing address
117 KITE ROAD, P.O. BOX 879, SWAINSBORO, GA 30401
(478) 289-1265
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN166580
GA
Other
Enumeration date
10/02/2009
Last updated
03/06/2012
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