Provider Demographics
NPI:1073508107
Name:MADIX, JAMES CURTIS (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CURTIS
Last Name:MADIX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2049
Mailing Address - Street 2:
Mailing Address - City:MOULTRIE
Mailing Address - State:GA
Mailing Address - Zip Code:31776-2049
Mailing Address - Country:US
Mailing Address - Phone:229-985-8802
Mailing Address - Fax:229-891-2016
Practice Address - Street 1:1703 MEADOWS LN
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-8915
Practice Address - Country:US
Practice Address - Phone:229-985-8802
Practice Address - Fax:229-891-2016
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0525192085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD90621Medicare UPIN
GA30BDKTVMedicare ID - Type Unspecified