Maddox, Mikelle A

Maddox, Mikelle A is an individual health care provider with primary practice located at 1613 N Mckenzie St , Foley AL 36535-2247. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Maddox, Mikelle A can be contacted via phone (251) 949-3710.

Contact Information

Primary practice address
1613 N Mckenzie St Foley AL 36535-2247
Phone: (251) 949-3710
Fax: (251) 949-3715
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22008 Alabama

Profile Details

NPI number 1770578726
LBN Legal business name Maddox, Mikelle A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2005
Last updated Nov 13th, 2020 - 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 1770578726 NPPES
Mississippi MEDICAID 03330541
Mississippi MEDICAID 210025
Mississippi MEDICAID 7100679480
Mississippi MEDICAID 105656800
Mississippi MEDICAID 240553

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