Organization
JOSE L MADARA JR M D PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE LAS LLAGAS MADARA JR. M.D. (PRESIDENT)
(662) 728-7711
Entity
Organization
Contact information
Practice address
102 HOTEL ST, BOONEVILLE, MS 38829-3303
(662) 728-7711
(662) 728-7713
Mailing address
102 HOTEL ST, BOONEVILLE, MS 38829-3303
(662) 728-7711
(662) 728-7713
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
7928
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00016361
—
MS
Enumeration date
06/16/2005
Last updated
08/14/2007
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