Individual
DR. MIKELLE A MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1613 N MCKENZIE ST, FOLEY, AL 36535-2247
(251) 949-3710
(251) 949-3715
Mailing address
1613 N MCKENZIE ST, FOLEY, AL 36535-2247
(251) 949-3479
(251) 949-3434
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22008
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03330541
—
MS
05
—
105656800
—
FL
05
—
210025
—
AL
05
—
240553
—
AL
05
—
7100679480
—
KY
Enumeration date
09/15/2005
Last updated
11/13/2020
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