Doctor Name: | MR. SCOTT ANTHONY MADDOX |
NPI Number: | 1285963199 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | R.N. |
License Number: | 742263 |
Business Practice Address: | 4301 Wilson Street Fort Sill, OK - 73503 |
Business Phone Number: | 5805582134 |
Business Fax Number: | 5805582314 |
Mailing Address: | 4301 Wilson Street, FORT SILL |
State: | OK |
Postal Code: | 73503 |
Phone Number: | 5805582134 |
Fax Number: | 5805582314 |
NPI Enumeration Date: | 12/24/2009 |
NPI Last Update Date: | 12/24/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC1500X |
License Number: | 742263 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |