Maddox, Owen
Maddox, Owen is an sole proprietor health care provider with primary practice located at 125 Parker Hill Ave , Roxbury Crossing MA 02120-2847. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Maddox, Owen can be contacted via phone (617) 754-6687.Contact Information
Primary practice address
125 Parker Hill Ave
Roxbury Crossing MA 02120-2847
Phone: (617) 754-6687
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 207995 | Massachusetts |
Profile Details
| NPI number | 1306831128 |
|---|---|
| LBN Legal business name | Maddox, Owen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 19th, 2005 |
| Last updated | Jan 6th, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306831128 | NPPES |
| Massachusetts | MEDICAID | 0136191 |
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