Maddock, Kurt A

Maddock, Kurt A is an individual health care provider with primary practice located at 2 S Hospital Dr , Murphysboro IL 62966-3333. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine. Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine is his primary health care specialty. Maddock, Kurt A can be contacted via phone (618) 684-1035.

Contact Information

Primary practice address
2 S Hospital Dr Murphysboro IL 62966-3333
Phone: (618) 684-1035
Fax: (618) 684-1036
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 01038293A Indiana
Allopathic & Osteopathic Physicians / Surgery 208600000X 036144660 Illinois
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine 2083P0011X 036.144660 Illinois

Profile Details

NPI number 1740253707
LBN Legal business name Maddock, Kurt A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Aug 3rd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740253707 NPPES
Indiana Other 000000599251 ANTHEM
Indiana Other P00658239 ANTHEM
Indiana MEDICAID 100318820A ANTHEM

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