Bruce R Maddern Md Pa
LBN: Bruce R Maddern Md Pa
Bruce R Maddern Md Pa is an health care organization with primary practice located at 10475 Centurion Pkwy N Suite 302, Jacksonville FL 32256-5003. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Otolaryngology, Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery. Allopathic & Osteopathic Physicians / Pediatric Otolaryngology is the primary health care specialty.
Bruce R Maddern Md Pa can be contacted via phone (904) 398-5437, or through Maddern, Bruce R via phone (904) 398-5437.
Contact Information
Primary practice address
10475 Centurion Pkwy N Suite 302
Jacksonville FL 32256-5003
Phone: (904) 398-5437
Fax: (904) 398-3077
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Otolaryngology | 207YP0228X | ||
| Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery | 207YX0905X |
Profile Details
| NPI number | 1225001589 |
|---|---|
| LBN Legal business name | Bruce R Maddern Md Pa |
| DBA Doing business as | |
| Authorized official | Maddern, Bruce R Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 8th, 2006 |
| Last updated | Sep 7th, 2007 - about 18 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225001589 | NPPES |
| Florida | Other | 8651 | AV MED |
| Florida | Other | 45553 | AV MED |
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