Provider Demographics
NPI:1629367958
Name:MADDEN, DIONYSOS DAVID (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:DIONYSOS
Middle Name:DAVID
Last Name:MADDEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:MR
Other - First Name:DION
Other - Middle Name:DAVID
Other - Last Name:MADDEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1320 CLEVELAND HWY
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721-8631
Mailing Address - Country:US
Mailing Address - Phone:706-272-9346
Mailing Address - Fax:706-272-9372
Practice Address - Street 1:1320 CLEVELAND HWY
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-8631
Practice Address - Country:US
Practice Address - Phone:706-272-9346
Practice Address - Fax:706-272-9372
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0228191835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy