Organization
RICARDO B MADDELA MD PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE LYNN NUNN (RECEPTIONIST)
27088269595
Entity
Organization
Contact information
Practice address
1413 N ELM ST, HENDERSON, KY 42420-2768
(270) 826-9595
(270) 826-3656
Mailing address
PO BOX 1548, HENDERSON, KY 42419-1548
(270) 826-9595
(270) 826-3656
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64193139
—
KY
Enumeration date
11/17/2010
Last updated
11/17/2010
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