MICHAEL MADDOX MENTAL HEALTH TECH NPI 1568768158

NPI Information

NPI: 1568768158
Provider Name: MICHAEL MADDOX, MENTAL HEALTH TECH
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
3903 INDIANAPOLIS BLVD
EAST CHICAGO, IN
ZIP 46312
Phone: (219) 473-1350
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Michael Maddox, MENTAL HEALTH TECH is a medical physician assistant in East Chicago, IN. Michael Maddox, MENTAL HEALTH TECH NPI is 1568768158. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3903 INDIANAPOLIS BLVD
EAST CHICAGO, IN
ZIP 46312-555
Phone: (219) 473-1350
Fax: (219) 392-6998

The enumeration date for this NPI number is 1/31/2011 and was last updated on 1/31/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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