Individual
MRS. HEATHER E MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
500 W. BROADWAY, MISSOULA, MT 59802-4003
(406) 721-5600
(406) 721-3907
Mailing address
P.O. BOX 7609, MISSOULA, MT 59807-7609
(406) 721-5600
(406) 721-3907
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101231026
VA
207Q00000X
Family Medicine Physician
Primary
11962
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010003105
—
VA
Enumeration date
09/12/2005
Last updated
01/11/2016
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