Individual
JACKSON W Q MADDUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E 28TH ST STE 1750, MINNEAPOLIS, MN 55407
(612) 863-4495
Mailing address
800 E 28TH ST STE 1750, MINNEAPOLIS, MN 55407-3723
(612) 863-4495
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
36055
KY
208100000X
Physical Medicine & Rehabilitation Physician
Primary
56201
MN
208100000X
Physical Medicine & Rehabilitation Physician
DR.0043168
CO
Other
Enumeration date
04/12/2006
Last updated
09/27/2018
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