Individual
JEFFREY THOMAS MADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-5304
Mailing address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-5304
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18369
ND
2085R0204X
Vascular & Interventional Radiology Physician
18369
ND
Other
Enumeration date
07/06/2016
Last updated
12/18/2023
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