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Individual

RICHARD B MADDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
4076 NEELY ROAD, FORT WAINWRIGHT, AK 99703
(907) 361-6028
(907) 361-4847
Mailing address
4076 NEELY ROAD, FORT WAINWRIGHT, AK 99703
(907) 361-6028
(907) 361-4847

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1159
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100761570A
OK
Enumeration date
08/02/2006
Last updated
11/05/2024
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