Doctor Name: | STEVE MADRON |
NPI Number: | 1083080501 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 1719 W Wyandotte Ave Sulphur, OK - 730864227 |
Business Phone Number: | 5806185381 |
Business Fax Number: | |
Mailing Address: | 1719 W Wyandotte Ave, SULPHUR |
State: | OK |
Postal Code: | 730864227 |
Phone Number: | 5806185381 |
Fax Number: | |
NPI Enumeration Date: | 08/19/2015 |
NPI Last Update Date: | 08/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |