Organization
CLARKSBURG SURGICAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY W MADDEN M.D. (PARTNER)
(304) 933-3855
Entity
Organization
Contact information
Practice address
527 MEDICAL PARK DR, STE 202, BRIDGEPORT, WV 26330-9009
(304) 933-3855
(304) 933-3859
Mailing address
527 MEDICAL PARK DR, SUITE 202, BRIDGEPORT, WV 26330-9008
(304) 933-3855
(304) 933-3859
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
18555
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020411000
—
WV
01
—
18555
WV BUSINESS LICENSE
WV
Enumeration date
05/28/2006
Last updated
11/02/2011
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